Electroconvulsive therapy in the elderly

Abstract

Electroconvulsive therapy (ECT) is one of the treatment modalities in psychiatry that has stood the test of time for years. ECT has been used in various psychiatric conditions in the elderly. Comorbid medical conditions and cognitive deficits have been the prime concerns in this population. The indications and contraindications of use of ECT in the elderly population are same as that in an adult. ECT has also been found to be effective in patients with Parkinson's disease and dementia. Pre-ECT evaluation and cognitive evaluation prior and during ECT are inevitable. The determination of right technique, dose, frequency, and assessment of side effects are prerequisites to the usage of ECT in elderly. Owing to risk of cognitive side effects, right unilateral ECT is preferred. In carefully selected indications, ECT may be a superior management modality than pharmacotherapy.