Neurocognitive Effects of Combined Electroconvulsive Therapy (ECT) and Venlafaxine in Geriatric Depression: Phase 1 of the PRIDE Study.
Repository Usage Stats
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.
SubjectCORE/PRIDE Work Group
Published Version (Please cite this version)10.1016/j.jagp.2019.10.003
Publication InfoWeiner, Richard; Lisanby, Sarah H; McClintock, Shawn M; Alexopoulos, George; Bailine, Samuel H; Bernhardt, Elisabeth; ... Kellner, Charles H (2019). Neurocognitive Effects of Combined Electroconvulsive Therapy (ECT) and Venlafaxine in Geriatric Depression: Phase 1 of the PRIDE Study. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. 10.1016/j.jagp.2019.10.003. Retrieved from https://hdl.handle.net/10161/19555.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
More InfoShow full item record
Professor of Psychiatry and Behavioral Sciences
Research efforts under my direction are in electroconvulsive therapy (ECT). First, in a study of unilateral versus bilateral ECT in elderly unilateral ECT non-responders, we have shown that switching to bilateral ECT is associated with a more substantial and enduring response. We have also shown that switching to bilateral ECT is, however, associated with an increase in memory impairment compared to continuing unilateral ECT. Other ongoing ECT work focuses on the effects of various types