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ECT and dementia

Moshe Isserles, Zafiris J Daskalakis, Sanjeev Kumar, Tarek K Rajji, Daniel M Blumberger
BACKGROUND: Dementia frequently presents with aggression, agitation, and disorganized behavior for which current treatment is partially effective and is associated with significant adverse effects. OBJECTIVE: The aim of this study was to retrospectively assess the clinical effectiveness and tolerability of electroconvulsive therapy (ECT) in a sample of patients with neuropsychiatric symptoms of dementia (NPS) and to explore factors associated with response and with cognitive adverse effects...
2017: Journal of Alzheimer's Disease: JAD
Oliver M Glass, Brent P Forester, Adriana P Hermida
BACKGROUND: Agitation in patients with dementia increases caretaker burden, increases healthcare costs, and worsens the patient's quality of life. Antipsychotic medications, commonly used for the treatment of agitation in patients with dementia have a box warning from the FDA for elevated mortality risk. Electroconvulsive therapy (ECT) has made significant advances over the past several years, and is efficacious in treating a wide range of psychiatric conditions. We provide a systematic review of published literature regarding the efficacy of ECT for the treatment of agitation in patients with dementia (major neurocognitive disorder)...
May 2017: International Psychogeriatrics
Timothy Edwin Lau, Prakash Kishor Babani, Lisa Anne McMurray
OBJECTIVE: There is emerging evidence that electroconvulsive therapy (ECT) can help with the behavioral and psychological symptoms of dementia. One of the most distressing behavioral symptoms of dementia is disruptive vocalization. Previous small case series have suggested that antidepressants and ECT can be beneficial for this distressing condition. The aim of this study was to describe the successful use of ECT in treating 5 patients with disruptive vocalization. METHODS: A retrospective chart review of 5 patients with dementia of mixed etiologies was conducted comparing pretreatment and posttreatment scores on the Cohen-Mansfield Agitation Inventory...
December 21, 2016: Journal of ECT
William M McDonald
There is increasing evidence for the efficacy of neuromodulation in the treatment of resistant mood disorders and emerging data supporting the use of neuromodulation in cognitive disorders. A significant minority of depressed elders do not respond to pharmacotherapy and/or psychotherapy. This has led clinicians to recommend the increasing use of electroconvulsive therapy (ECT) in the treatment of medication-resistant or life-threatening geriatric depression. Multiple studies have supported the safety and efficacy of ECT in the elderly, yet ECT is associated with side effects including cardiovascular and cognitive side effects...
December 2016: American Journal of Geriatric Psychiatry
Jie Guo, Chunxiao Yang, Jiajia Yang, Yang Yao
Vascular dementia (VD) is the second most common cause of cognitive impairment in the elderly population. Our study aims to investigate the neuroprotective effects of glycyrrhizic acid (GA), a major active constituent of Glycyrrhiza glabra root, in a VD rat model induced by permanent occlusion of the bilateral common carotid arteries. Spatial cognitive function was examined by the Morris water maze test and synaptic plasticity was explored by assessing long-term potentiation. The results showed that GA (20 mg/kg for 5 days) significantly improved the performance of learning and memory of VD rats in the Morris water maze test and attenuated induction of long-term potentiation...
2016: CNS & Neurological Disorders Drug Targets
Åke Berggren, Lars Gustafson, Peter Höglund, Aki Johanson
BACKGROUND: In this study, the long term effects of ECT on patients with depression were investigated through repeated rCBF and EEG measures as well as clinical characteristics over several years. The aim of the investigation was to establish an association with the eventual development of dementia. METHOD: A cohort of forty-nine patients (21 men and 28 women) with a mean age of 61 years underwent ECT. A subsequent evaluation from medical records and three rating-scales for diagnosis of Alzheimer´s disease (AD), fronto-temporal dementia (FTD), and for vascular dementia (VaD), revealed that 17 patients (8 men and 9 women), had developed dementia...
August 2016: Journal of Affective Disorders
Qing-E Zhang, Sha Sha, Gabor S Ungvari, Helen F K Chiu, Chee H Ng, Hong-Bo He, Brent P Forester, Yu-Tao Xiang
PURPOSE: Little is known about the clinical characteristics of patients with dementia receiving electroconvulsive therapy (ECT) for the treatment of behavioral symptoms. This study examined the demographic and clinical profile of patients with dementia receiving ECT in China. METHODS: This was a retrospective, case-control study. The sample was composed of 23 patients with dementia treated with ECT and 71 sex- and age-matched controls treated for a period of 8 years (2007-2014) at the National Clinical Research Centre of Mental Disorders, China...
September 2016: Journal of ECT
A-S Seigneurie, F Sauvanaud, F Limosin
INTRODUCTION: Tardive dyskinesia (TD) is a movement disorder of tongue, jawbone, trunk and/or limbs that may appear after a prolonged use of dopamine receptor blocking agents (after 3 months of treatment or after 1 month for patients over 60), and that are present during at least four consecutive weeks. TD is a frequent side effect of both classical neuroleptics and new generation antipsychotic drugs. The prevalence of iatrogenic TD is between 24 and 32 % after treatment with classical neuroleptics and about 13 % after treatment with a new generation antipsychotic...
June 2016: L'Encéphale
Tamela D McClam, Christopher M Marano, Paul B Rosenberg, Constantine G Lyketsos
Neurocognitive impairment due to Alzheimer's disease (previously termed Alzheimer's dementia) (AD) is the most common form of cognitive impairment worldwide. Given the anticipated increase in the population aged 65 and over, the prevalence of persons with AD is expected to increase exponentially during the next 30 years. Noncognitive neuropsychiatric symptoms (NPS) commonly occur in AD and are associated with adverse outcomes for patients and their caregivers. This review summarizes randomized, controlled trials (RCTs) published between 2004 and 2014 with a primary outcome measure of change in symptom severity for NPS in AD...
September 2015: Harvard Review of Psychiatry
Lu Li, Zhi-Min Wang, Helen F K Chiu, Gabor S Ungvari, Chee H Ng, Ada W Y Tse, Grace K I Lok, Jian-Song Zhou, Yu-Tao Xiang
BACKGROUND: Little is known about psychiatric pharmacotherapy and somatic treatments in dementia in China. This study examined the prescription patterns of psychotropic medications and use of electroconvulsive therapy (ECT) in dementia patients hospitalized in a psychiatric institution in Beijing, China. METHODS: This was a retrospective chart review of 401 patients with dementia treated over a period of 7 years (2007 - 2013) in a university-affiliated psychiatric institution in Beijing...
September 2015: International Journal of Clinical Pharmacology and Therapeutics
Mardien L Oudega, Annemieke Dols, Ilse Adelerhof, Maarten Rozing, Mike P Wattjes, Hannie C Comijs, Frederik Barkhof, Piet Eikelenboom, Max L Stek, Eric van Exel
BACKGROUND: Depression and cognitive decline are highly prevalent and often coexisting, however, the association between depression and dementia remains unclear. White matter hyperintensities (WMH), medial temporal lobe atrophy (MTA) and global cortical atrophy (GCA) are associated with depression, mild cognitive impairment and dementia; these structural abnormalities may therefore represent a common underlying mechanism of these diseases. We conducted a naturalistic prospective follow-up study in patients with severe geriatric depression who were formerly treated with ECT...
October 1, 2015: Journal of Affective Disorders
Gro Strømnes Dybedal, Lars Tanum, Kjetil Sundet, Tor Magne Bjølseth
OBJECTIVE: Electroconvulsive therapy (ECT) is an effective biological treatment option for severely depressed elderly patients; however, it can cause cognitive side effects, including anterograde and retrograde amnesia. Elderly patients with "cognitive impairment no dementia" (CIND) are reported as being more vulnerable to the cognitive side effects of ECT compared with patients with "no cognitive impairment" (NCI). The few studies that have reached this conclusion can be criticized for using insensitive outcome measures...
2015: Clinical Neuropsychologist
Giulia Serra, Athanasios Koukopoulos, Lavinia De Chiara, Alexia E Koukopoulos, Leonardo Tondo, Paolo Girardi, Ross J Baldessarini, Gino Serra
BACKGROUND: Developing safe and effective long-term treatments for bipolar disorder remains a major challenge. Given available treatments, patients with bipolar disorder remain unwell in half of long-term follow-up, mostly in depression. As memantine, an N-methyl-D-aspartate (NMDA)-glutamate receptor antagonist used to treat dementia, has been proposed for testing in bipolar disorder, we carried out a 3 + 3-year, mirror-image, chart-review study of the effects of adding memantine to stably continued, but insufficiently effective, ongoing mood-stabilizing treatments...
January 2015: Journal of Clinical Psychiatry
Suna Su Aksay, Lucrezia Hausner, Lutz Frölich, Alexander Sartorius
Dementia-related behavioral disturbances are mostly treated with antipsychotics; however, the observed beneficial effects are modest and the risk of serious adverse effects high. We report the case of a 57-year-old woman with severe early-onset Alzheimer's disease and severe agitation, whom we treated with electroconvulsive therapy (ECT). A significant clinical improvement was achieved over eight ECT sessions, which were tolerated well without cognitive worsening, and lasted approximately 3 months. Our case demonstrates the safe and effective use of ECT in pharmacotherapy-resistant severe agitation in Alzheimer's disease...
2014: Neuropsychiatric Disease and Treatment
Davin K Quinn, Christopher C Abbott
BACKGROUND: Neurologic deterioration occurring days to weeks after a cerebral hypoxic event accompanied by diffuse white matter demyelination is called delayed posthypoxic leukoencephalopathy (DPHL). Manifestations of DPHL are diverse and include dementia, gait disturbance, incontinence, pyramidal tract signs, parkinsonism, chorea, mood and thought disorders, akinetic mutism, and rarely catatonia. METHODS: We report a case of malignant catatonia in a patient diagnosed with DPHL that was refractory to electroconvulsive therapy (ECT) and review the literature on catatonia in DPHL...
November 2014: Psychosomatics
Folabo Y Dare, Keith G Rasmussen
For patients who lack capacity to consent to electroconvulsive therapy (ECT) for various reasons (intellectual disability, severe mental illness, dementia, etc), court approval must be obtained to proceed with the treatments. We reviewed our experiences on a busy tertiary center ECT service in which we have treated 24 patients in recent years under the auspices of court approval for consent. We found that these patients generally tolerated the treatments well and had noticeable improvement in their symptoms as well as overall better quality of life...
September 2015: Journal of ECT
Peter Manu, Sameer Khan, Rajiv Radhakrishnan, Mark J Russ, John M Kane, Christoph U Correll
BACKGROUND: Psychiatric hospital readmissions correlate with illness severity, drug selection, and compliance with treatment in the outpatient setting. The risk factors for psychiatric rehospitalization have been mainly assessed in databases lacking information regarding somatic comorbidity and anthropometric variables, such as body mass index (BMI), which are known to predict readmissions in nonpsychiatric settings. OBJECTIVE: To determine independent predictors of 1-year readmission occurring among unselected adults consecutively admitted for treatment of severe mental illness to an academic, freestanding psychiatric hospital in New York City from August 2010 through January 2011...
June 2014: Journal of Clinical Psychiatry
Froukje H Woudstra, Aida T van de Poel-Mustafayeva, Maya V van der Ploeg, Jeroen J de Vries, Rixt F Riemersma van der Lek, Gerbrand J Izaks
BACKGROUND: Dementia is generally considered an irreversible process of cognitive decline that can be caused by different neurodegenerative diseases. However, in some cases, dementia is caused by a non-neurodegenerative disease, such as an affective disorder. In these cases, the dementia can be reversible. Nevertheless, cognitive symptoms due to an affective disorder are often difficult to distinguish from a depressed mood due to a neurodegenerative disease. Especially in elderly patients with a history of affective disorder, a potentially reversible cause can be missed...
2014: BMC Research Notes
M A Salib
The patient described was a 68-year-old man presenting with a severe, subacute depressive state with rapid decline in memory, psychomotor retardation and refusal to eat, who was referred by the medical team for ECT. His memory impairment could not be explained within the context of his depressed mood and he was eventually found to have a primary cerebral lymphoma of the non-Hodgkin's type. He died 10 weeks after initial psychiatric assessment.
2001: International Journal of Psychiatry in Clinical Practice
Deepa Acharya, David G Harper, Eric D Achtyes, Stephen J Seiner, Jack A Mahdasian, Louis J Nykamp, Lesley Adkison, Lori Van der Schuur White, Shawn M McClintock, Manjola Ujkaj, Donald A Davidoff, Brent P Forester
OBJECTIVE: Agitation and aggression are among the most frequent and disruptive behavioral complications of dementia that contribute to increased cost of care, hospitalization, caregiver burden, and risk of premature institutionalization. This current study examined the safety and efficacy of electroconvulsive therapy (ECT) as a treatment for behavioral disturbances in dementia. We hypothesized that ECT would result in reduced agitated and aggressive behaviors between baseline and discharge...
March 2015: International Journal of Geriatric Psychiatry
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