Fixed high-dose electroconvulsive therapy in the elderly with depression: a double-blind, randomized comparison of efficacy and tolerability between unilateral and bilateral electrode placement.
OBJECTIVE
To evaluate efficacy and tolerability of unilateral (RUL) and bilateral (BL) electroconvulsive therapy (ECT) in the elderly with depression.


METHODS
Thirty-nine elderly inpatients with major depression referred to ECT were randomized into RUL or BL ECT, using high, fixed electrical doses. Cognition and depression severity were assessed before, during, and 1 month after treatment. Adverse effects were assessed after each session.


RESULTS
Remission rates for RUL ECT (88.2%) and BL ECT (68.2%) were similar (P = 0.25). Reduction rates of depressive symptoms were also similar. There were no serious adverse events. There were more adverse effects in the BL ECT group (P = 0.05). BL ECT showed more short-term cognitive impairment, whereas improvements in neuropsychological scores were seen in both groups.


CONCLUSIONS
In elderly depressive subjects, high-dose RUL ECT is as effective as BL ECT yet produces less adverse effects and less cognitive impairment.
Stoppe
Alberto
A
Instituto de Psiquiatria do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Brazil. astoppej@uol.com.br
Louzã
Mario
M
Rosa
Moacyr
M
Gil
Gislaine
G
Rigonatti
Sérgio
S
D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003866:Depressive Disorder / Q000628:therapy*; D004311:Double-Blind Method; D004565:Electroconvulsive Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome