TY - JOUR
T1 - Neurocognitive Effects of Combined Electroconvulsive Therapy (ECT) and Venlafaxine in Geriatric Depression
T2 - Phase 1 of the PRIDE Study
AU - CORE/PRIDE Work Group
AU - Lisanby, Sarah H.
AU - McClintock, Shawn M.
AU - Alexopoulos, George
AU - Bailine, Samuel H.
AU - Bernhardt, Elisabeth
AU - Briggs, Mimi C.
AU - Cullum, C. Munro
AU - Deng, Zhi De
AU - Dooley, Mary
AU - Geduldig, Emma T.
AU - Greenberg, Robert M.
AU - Husain, Mustafa M.
AU - Kaliora, Styliani
AU - Knapp, Rebecca G.
AU - Latoussakis, Vassilios
AU - Liebman, Lauren S.
AU - McCall, William V.
AU - Mueller, Martina
AU - Petrides, Georgios
AU - Prudic, Joan
AU - Rosenquist, Peter B.
AU - Rudorfer, Matthew V.
AU - Sampson, Shirlene
AU - Teklehaimanot, Abeba A.
AU - Tobias, Kristen G.
AU - Weiner, Richard D.
AU - Young, Robert C.
AU - Kellner, Charles H.
N1 - Publisher Copyright:
© 2019 American Association for Geriatric Psychiatry
PY - 2020/3
Y1 - 2020/3
N2 - Objective: There is limited information regarding the tolerability of electroconvulsive therapy (ECT) combined with pharmacotherapy in elderly adults with major depressive disorder (MDD). Addressing this gap, we report acute neurocognitive outcomes from Phase 1 of the Prolonging Remission in Depressed Elderly (PRIDE) study. Methods: Elderly adults (age ≥60) with MDD received an acute course of 6 times seizure threshold right unilateral ultrabrief pulse (RUL-UB) ECT. Venlafaxine was initiated during the first treatment week and continued throughout the study. A comprehensive neurocognitive battery was administered at baseline and 72 hours following the last ECT session. Statistical significance was defined as a two-sided p-value of less than 0.05. Results: A total of 240 elderly adults were enrolled. Neurocognitive performance acutely declined post ECT on measures of psychomotor and verbal processing speed, autobiographical memory consistency, short-term verbal recall and recognition of learned words, phonemic fluency, and complex visual scanning/cognitive flexibility. The magnitude of change from baseline to end for most neurocognitive measures was modest. Conclusion: This is the first study to characterize the neurocognitive effects of combined RUL-UB ECT and venlafaxine in elderly adults with MDD and provides new evidence for the tolerability of RUL-UB ECT in an elderly sample. Of the cognitive domains assessed, only phonemic fluency, complex visual scanning, and cognitive flexibility qualitatively declined from low average to mildly impaired. While some acute changes in neurocognitive performance were statistically significant, the majority of the indices as based on the effect sizes remained relatively stable.
AB - Objective: There is limited information regarding the tolerability of electroconvulsive therapy (ECT) combined with pharmacotherapy in elderly adults with major depressive disorder (MDD). Addressing this gap, we report acute neurocognitive outcomes from Phase 1 of the Prolonging Remission in Depressed Elderly (PRIDE) study. Methods: Elderly adults (age ≥60) with MDD received an acute course of 6 times seizure threshold right unilateral ultrabrief pulse (RUL-UB) ECT. Venlafaxine was initiated during the first treatment week and continued throughout the study. A comprehensive neurocognitive battery was administered at baseline and 72 hours following the last ECT session. Statistical significance was defined as a two-sided p-value of less than 0.05. Results: A total of 240 elderly adults were enrolled. Neurocognitive performance acutely declined post ECT on measures of psychomotor and verbal processing speed, autobiographical memory consistency, short-term verbal recall and recognition of learned words, phonemic fluency, and complex visual scanning/cognitive flexibility. The magnitude of change from baseline to end for most neurocognitive measures was modest. Conclusion: This is the first study to characterize the neurocognitive effects of combined RUL-UB ECT and venlafaxine in elderly adults with MDD and provides new evidence for the tolerability of RUL-UB ECT in an elderly sample. Of the cognitive domains assessed, only phonemic fluency, complex visual scanning, and cognitive flexibility qualitatively declined from low average to mildly impaired. While some acute changes in neurocognitive performance were statistically significant, the majority of the indices as based on the effect sizes remained relatively stable.
KW - Major depressive disorder
KW - electroconvulsive therapy
KW - geriatric
KW - memory
KW - neuropsychology
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UR - http://www.scopus.com/inward/citedby.url?scp=85075526174&partnerID=8YFLogxK
U2 - 10.1016/j.jagp.2019.10.003
DO - 10.1016/j.jagp.2019.10.003
M3 - Article
C2 - 31706638
AN - SCOPUS:85075526174
SN - 1064-7481
VL - 28
SP - 304
EP - 316
JO - American Journal of Geriatric Psychiatry
JF - American Journal of Geriatric Psychiatry
IS - 3
ER -