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

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. We conducted a PRISMA-guided systematic review of the literature. We searched five major databases, inc...

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Bibliographic Details
Published in:International psychogeriatrics 2024-10, Vol.36 (10), p.864-879
Main Authors: Bachu, Anil K., Kotapati, Vijaya Padma, Kainth, Tejasvi, Patel, Rikinkumar, Youssef, Nagy A., Tampi, Rajesh R.
Format: Article
Language:English
Subjects:
Amnesia
Anxiety
Behavior
Caregivers
Case reports
Catatonia
Chart reviews
Clinical research
Clinical trials
Cognition & reasoning
Cognitive ability
Cognitive impairment
Cognitive-behavioral factors
Confusion
Critical incidents
Dementia
Electroconvulsive therapy
Inpatient care
Literature reviews
Mental depression
Mortality
Older people
Patients
Psychosis
Psychotic symptoms
Short term memory
Side effects
Systematic review
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Summary: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. 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. 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. The studies were conducted in the in-patient setting. Seven hundred and ninety total patients over the age of 60 years were added. 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. 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.
ISSN:1041-6102
1741-203X
DOI:10.1017/S104161022300039X