Nine elderly patients with major depression were followed for outcome of continuation ECT. All nine patients had poor response to pharmacotherapy of the index episode, favorable response to acute treatment with ECT and, to varying degrees, previous failure of prophylactic pharmacotherapy. Four of the nine patients complied with continuation ECT as recommended for periods of 9 months to 1 year; these patients remained essentially well during the follow-up period, while the five who stopped the treatment prematurely fared poorly (one died, one required chronic hospitalization and three were rehospitalized acutely). These findings suggest the need for controlled studies of continuation ECT in geriatric depression.
KEY woms-Geriatric, depression, ECT (electroconvulsive therapy), continuation, maintenance.
Despite progress in pharmacologic treatment, the long-term outcome of geriatric major depression can be unfavorable. Studies of community-treated geriatric depressives suggest that only 25-30% achieve sustained recovery . Data from mixed-age populations have shown that 50% of those who recovered with electroconvulsive therapy (ECT) relapse within the first year . The failure rate of prophylactic pharmacotherapy after ECT ranges from 25 to 28% at 6-7 months (