J Korean Geriatr Psychiatry.
2013 Oct;17(2):47-55.
Treatment of Late-Life Depression by Brain Stimulation Techniques
- Affiliations
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- 1Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea.
- 2Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea.
- 3Department of Psychiatry, Dongguk University International Hospital, Dongguk University Medical School, Goyang, Korea. kys@snu.ac.kr
Abstract
- Due to the low response rate of antidepressant treatment in late-life depression, brain stimulation techniques should be considered when treating elderly patients. Electroconvulsive therapy (ECT) is one of the most frequently used brain stimulation techniques, and shows favorable outcome and acceptable tolerability in the treatment of late-life depression. Hemodynamic change and cognitive impairment are common side effects of ECT, which are transient in most cases. Since cognitive impairment can lead to treatment non-compliance, it should be minimized by controlling electrode position, pulse-width, treatment frequency, etc. Because ECT is followed by rapid cardiovascular change, risk factors should be evaluated and managed properly. Transcranial magnetic stimulation (TMS) and magnetic seizure therapy (MST) are also shown to be effective in treating depression, with less cognitive impairment. However, further research is needed to establish their efficacy in late-life depression.
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