Can ECT-induced cognitive effects be altered pharmacologically?

1. A systematic review of the literature revealed twelve clinical trials that evaluated nine different drugs, and used three different conceptual models to prevent, restore or treat ECT-induced cognitive deficits. 2. This review indicated inconclusive results regarding clinical utility of any of the drugs. 3. Major factors discussed include the complexities involved in the evaluation of ECT-induced cognitive deficits, and the techniques of evaluating changes in cognitive functions. 4. Our conclusion is that future research should emphasize understanding the neural mechanisms related to ECT-induced cognitive deficits. We suggest several areas for future exploration.

Depression in the elderly: a treatable disorder.

Up to 15% of elderly women may suffer from depression. Patients with this disorder present with change in mood or diminished interest or pleasure in usual activities, as well as a variety of other neurovegetative symptoms. Depression is amenable to treatment, and a wide range of drug and nonpharmacologic modalities may be useful. The mere action of seeking professional help signals that the depressed patient has begun to take control of the situation and serves as a promising sign for recovery. The tricyclic antidepressants have a long history of use for the treatment of depression and are probably the most widely used agents for this indication, despite numerous adverse effects. Bupropion and the new selective serotonin reuptake inhibitors are effective in treating depression and are better tolerated than the tricyclics. For this reason, they may be particularly useful for treating depression in the elderly.