Neurocognitive Effects of Combined Electroconvulsive Therapy (ECT) and Venlafaxine in Geriatric Depression: Phase 1 of the PRIDE Study.

Lisanby, Sarah H

McClintock, Shawn M

Alexopoulos, George

Bailine, Samuel H

Bernhardt, Elisabeth

Briggs, Mimi C

Cullum, C Munro

Deng, Zhi-De

Dooley, Mary

Geduldig, Emma T

Greenberg, Robert M

Husain, Mustafa M

Kaliora, Styliani

Knapp, Rebecca G

Latoussakis, Vassilios

Liebman, Lauren S

McCall, William V

Mueller, Martina

Petrides, Georgios

Prudic, Joan

Rosenquist, Peter B

Rudorfer, Matthew V

Sampson, Shirlene

Teklehaimanot, Abeba A

Tobias, Kristen G

Weiner, Richard D

Young, Robert C

Kellner, Charles H

CORE/PRIDE Work Group

2019-12-02T00:57:02Z

2019-12-02T00:57:02Z

2019-10-12

2019-12-02T00:57:01Z

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.

S1064-7481(19)30528-7

1064-7481

1545-7214

https://hdl.handle.net/10161/19555

eng

Elsevier BV

The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry

10.1016/j.jagp.2019.10.003

CORE/PRIDE Work Group

Neurocognitive Effects of Combined Electroconvulsive Therapy (ECT) and Venlafaxine in Geriatric Depression: Phase 1 of the PRIDE Study.

Journal article

Lisanby, Sarah H|0000-0003-2037-6470

Weiner, Richard D|0009-0008-9758-2073

School of Medicine

Duke

Psychiatry & Behavioral Sciences, Brain Stimulation and Neurophysiology

Psychiatry & Behavioral Sciences

Clinical Science Departments

Published