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Current Psychiatry Reports
Erschienen in: Current Psychiatry Reports 7/2015

01.07.2015 | Geriatric Disorders (W McDonald, Section Editor)

Neuromodulation Therapies for Geriatric Depression

verfasst von: Verònica Gálvez, Kerrie-Anne Ho, Angelo Alonzo, Donel Martin, Duncan George, Colleen K. Loo

Erschienen in: Current Psychiatry Reports | Ausgabe 7/2015

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Abstract

Depression is frequent in old age and its prognosis is poorer than in younger populations. The use of pharmacological treatments in geriatric depression is limited by specific pharmacodynamic age-related factors that can diminish tolerability and increase the risk of drug interactions. The possibility of modulating cerebral activity using brain stimulation techniques could result in treating geriatric depression more effectively while reducing systemic side effects and medication interactions. This may subsequently improve treatment adherence and overall prognosis in the older patient. Among clinically available neuromodulatory techniques, electroconvulsive therapy (ECT) remains the gold standard for the treatment of severe depression in the elderly. Studies have proven that ECT is more effective and has a faster onset of action than antidepressants in the treatment of severe, unipolar, geriatric depression and that older age is a predictor of rapid ECT response and remission. The application of novel and more tolerable forms of ECT for geriatric depression is currently being examined. Preliminary results suggest that right unilateral ultrabrief ECT (RUL-UB ECT) is a promising intervention, with similar efficacy to brief-pulse ECT and fewer adverse cognitive effects. Overall findings in repetitive transcranial magnetic stimulation (rTMS) suggest that it is a safe intervention in geriatric depression. Higher rTMS stimulation intensity and more treatments may need to be given in the elderly to achieve optimal results. There is no specific data on vagus nerve stimulation in the elderly. Transcranial direct current stimulation, magnetic seizure therapy and deep brain stimulation are currently experimental, and more data from geriatric samples is needed.
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Metadaten
Titel
Neuromodulation Therapies for Geriatric Depression
verfasst von
Verònica Gálvez
Kerrie-Anne Ho
Angelo Alonzo
Donel Martin
Duncan George
Colleen K. Loo
Publikationsdatum
01.07.2015
Verlag
Springer US
Erschienen in
Current Psychiatry Reports / Ausgabe 7/2015
Print ISSN: 1523-3812
Elektronische ISSN: 1535-1645
DOI
https://doi.org/10.1007/s11920-015-0592-y

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