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Electroconvulsive Therapy for the Elderly: A Review
Charles F. Zorumski; Eugene H. Rubin; William J. Burke
Psychiatric Services 1988; doi:
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Department of psychiatry at Washington University School of Medicine, 4940 Audubon Ayenue, St. Louis, Missouri 63110

Department of psychiatry at the University of Nebraska in Omaha

American Psychiatric Association

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Abstract

Treatment of psychiatric disorders among the elderly is complicated by such factors as high incidence of medical illness and changes in drug metabolism; electroconvulsive therapy (ECT) is considered a reasonable treatment alternative for the elderly for several psychiatric syndromes. The authors review indications, complications, and precautions related to ECT for older patients. The primary indication is major depression; about 80 percent of elderly patients respond favorably. ECT appears less effective for depression secondary to dementia or somatization disorder. Although ECT is relatively safe for the elderly, up to one-third may experience a complication that interferes with treatment. Careful pre-ECT medical evaluation is essential, with special attention to cardiovascular factors and to concurrent medications.

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