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Electroconvulsive therapy in individuals with dementia/major NCD presenting with behavioral symptoms: a systematic review

Published online by Cambridge University Press:  12 May 2023

Anil K. Bachu Open the ORCID record for Anil K. Bachu [Opens in a new window] ,
Vijaya Padma Kotapati ,
Tejasvi Kainth Open the ORCID record for Tejasvi Kainth [Opens in a new window] ,
Rikinkumar Patel ,
Nagy A. Youssef  and
Rajesh R. Tampi Open the ORCID record for Rajesh R. Tampi [Opens in a new window]
Anil K. Bachu*
Affiliation:
Department of Psychiatry, Baptist Health - UAMS Psychiatry Residency Education Program, North Little Rock, AR, USA Allegheny Clinic, Psychiatry and Behavior Health Institute, Pittsburgh, PA, USA
Vijaya Padma Kotapati
Affiliation:
Department of Psychiatry, Baptist Health - UAMS Psychiatry Residency Education Program, North Little Rock, AR, USA
Tejasvi Kainth
Affiliation:
Department of Biomedical informatics, Stony Brook University, New York, NY, USA
Rikinkumar Patel
Affiliation:
Department of Psychiatry, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
Nagy A. Youssef
Affiliation:
Department of Psychiatry and Behavioral Health, Ohio State University College of Medicine, Columbus, OH, USA
Rajesh R. Tampi
Affiliation:
Department of Psychiatry, Creighton University School of Medicine, Omaha, NE, USA Department of Psychiatry, Yale School of Medicine (YSM), New Haven, CT, USA
*
Correspondence should be addressed to: Anil K. Bachu, Department of Psychiatry, Baptist Health - UAMS Psychiatry Residency Education Program, North Little Rock, AR, USA. Tel: 9377508431. E-mail: anilbachu0181@gmail.com
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Abstract

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.

Keywords

Electroconvulsive therapyECTaggressionDementia/Major NCDagitationbipolar disorderdepression
Type
Review Article
Information
International Psychogeriatrics , First View , pp. 1 - 16
Copyright
© International Psychogeriatric Association 2023

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