Elektroconvulsietherapie in de behandeling van depressie bij ouderen

Translated title of the contribution: Electroconvulsive therapy in late life depression: A review

M. L. Stek*, A. T.F. Beekman, B. Verwey

*Corresponding author for this work

Research output: Contribution to journalArticleProfessional


Electroconvulsive therapy is an important treatment of depressive states in late life. However in the Netherlands ECT is not often practiced and mostly indicated after a long period of fruitless clinical therapy. The primary aims of this literature study were to review the efficacy of ECT in late life depression, to identify predictors of good response, to discuss contraindications, side effects and finally modifications of technique. Eighteen studies were found addressing the topic of efficacy. Outcome ranged between 50%-100% clinically significant improvement. Positive predictors are melancholic features and delusional depression. Unlike in younger patients hypochondriacal symptoms and anxiety do not predict a negative outcome in older patients. ECT has been used succesfully in depression complicated by dementia, cognitive decline and cerebrovascular disease. Depression in Parkinson's disease may be a special indication where ECT may have a positive effect on motor symptoms. There are no firm indications of long term cognitive decline associated with ECT. Guidelines for practicing ECT (unipolar, brief pulse and anaesthesia) are in line with the state of the art in the literature. It is concluded that, especially in severe depression associated with comorbidity, current Dutch practice in using ECT, often leads to unwarranted delay.

Translated title of the contributionElectroconvulsive therapy in late life depression: A review
Original languageDutch
Pages (from-to)106-112
Number of pages7
JournalTijdschrift voor Gerontologie en Geriatrie
Issue number3
Publication statusPublished - 1997

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