title: Prevention of relapse with maintenance electroconvulsive therapy in elderly patients with major depressive episode.
abstract: OBJECTIVE
  To evaluate the effectiveness and safety of maintenance electroconvulsive therapy (mECT) in elderly patients with treatment-resistant Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition major depressive episode.
  
  
  METHODS
  Seven elderly patients with treatment-resistant major depressive episode were treated with a complete ECT cycle. Thereafter, they received one monthly ECT session as maintenance for 1 year. Response to treatment was defined as at least a 50% drop from baseline on the Hamilton Depression Rating Scale (HamD) and remission as not meeting criteria for major depression, a HamD score of 7 or less, and Clinical Global Impressions-Severity of Illness score of 1. We compared their response with the response of 7 elderly patients with treatment-resistant major depression who were treated with a full cycle of ECT but did not receive mECT (non-mECT). We compared the 2 groups for the number of relapses or recurrences of major depressive episodes after remission was achieved; a relapse or a recurrence occurred when HamD scores were 14 or higher, or when Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision major depressive episode criteria were met, or when Clinical Global Impressions-Severity of Illness score was 3 or higher and increased by at least 2 points from response/remission.
  
  
  RESULTS
  The mECT group (4 women and 3 men; mean age, 73 years) had significantly less mean relapses/recurrences (0 vs 1.57) and hospitalizations (0 vs 1) and received less drug treatment than the nonMECT group (similar for age and sex composition) during the 12-month follow-up period. All patients with mECT improved during treatment and did not relapse.
  
  
  CONCLUSIONS
  Maintenance ECT protected elderly patients from recurrent depressive episodes from relapsing/recurring more than standard ECT.
authors.affiliation: NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University of Rome, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Rapinesi
authors.forename: Georgios Demetrios
authors.initials: GD
authors.lastname: Kotzalidis
authors.forename: Daniele
authors.initials: D
authors.lastname: Serata
authors.forename: Antonio
authors.initials: A
authors.lastname: Del Casale
authors.forename: Paola
authors.initials: P
authors.lastname: Scatena
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Mazzarini
authors.forename: Federica
authors.initials: F
authors.lastname: Caccia
authors.forename: Roberto
authors.initials: R
authors.lastname: Brugnoli
authors.forename: Paolo
authors.initials: P
authors.lastname: Carbonetti
authors.forename: Claudio
authors.initials: C
authors.lastname: Fensore
authors.forename: Paolo
authors.initials: P
authors.lastname: Girardi
mesh_terms: D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000523:psychology / Q000628:therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D000077152:Olanzapine; D011569:Psychiatric Status Rating Scales; D055502:Secondary Prevention; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000077152:Olanzapine