Journal
INTERNATIONAL PSYCHOGERIATRICS
Volume -, Issue -, Pages -Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S104161022300039X
Keywords
Electroconvulsive therapy; ECT; aggression; Dementia; Major NCD; agitation; bipolar disorder; depression
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This study systematically reviewed the literature on the use of electroconvulsive therapy (ECT) in patients with dementia/major NCD presenting with behavioral symptoms. The results showed that ECT can effectively alleviate behavioral symptoms in these patients, but sometimes adverse events may occur.
Objective:This study aims to systematically review the literature on using electroconvulsive therapy (ECT) in patients with dementia/major NCD (Neuro cognitive disorder) presenting with behavioral symptoms. Design:We conducted a PRISMA-guided systematic review of the literature. We searched five major databases, including PubMed, Medline, Embase, Cochrane, and registry (ClinicalTrials.gov), collaborating with ECT and dementia/major NCD as our search terms. Measurements:Out of 445 published papers and four clinical trials, only 43 papers and three clinical trials met the criteria. There were 22 case reports, 14 case series, 4 retrospective chart reviews, 1 retrospective case-control study, 1 randomized controlled trial, and 2 ongoing trials. We evaluated existing evidence for using ECT in dementia/major NCD patients with depressive symptoms, agitation and aggression, psychotic symptoms, catatonia, Lewy body dementia/major NCD, manic symptoms, and a combination of these symptoms. Settings:The studies were conducted in the in-patient setting. Participants:Seven hundred and ninety total patients over the age of 60 years were added. Results:All reviewed studies reported symptomatic benefits in treating behavioral symptoms in individuals with dementia/major NCD. While transient confusion, short-term memory loss, and cognitive impairment were common side effects, most studies found no serious side effects from ECT use. Conclusion:Current evidence from a systematic review of 46 studies indicates that ECT benefits specific individuals with dementia/major NCD and behavioral symptoms, but sometimes adverse events may limit its use in these vulnerable individuals.
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