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302 - The Effectiveness and Safety of Electroconvulsive Therapy for Treatment Refractory Agitation or Aggression in Major Neurocognitive Disorder

Published online by Cambridge University Press:  04 November 2020

Simon Woo ,
Peter Chan ,
Robyn E Waxman ,
Sarah Elmi ,
Mafalda Musacchio ,
Michael Wilkins-Ho  and
Claire Docherty
Simon Woo
Affiliation:
Department of Psychiatry, University of British Columbia Department of Psychiatry, Royal Columbian Hospital
Peter Chan
Affiliation:
Department of Psychiatry, University of British Columbia Department of Psychiatry, Vancouver General Hospital
Robyn E Waxman
Affiliation:
Department of Psychiatry, University of Toronto Centre for Addiction and Mental Health Ontario Shores Centre for Mental Health Sciences
Sarah Elmi
Affiliation:
Ontario Shores Centre for Mental Health Sciences
Mafalda Musacchio
Affiliation:
Department of Psychiatry, University of British Columbia Parkview Tertiary Intensive Older Adult Mental Health Unit
Michael Wilkins-Ho
Affiliation:
Department of Psychiatry, University of British Columbia Department of Psychiatry, Vancouver General Hospital
Claire Docherty
Affiliation:
Department of Psychiatry, University of British Columbia

Abstract

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Introduction:

Fifty to ninety percent of individuals with Major Neurocognitive Disorder (MNCD) have Neuropsychiatric Symptoms (NPS)1. Agitation and aggression are amongst the most persistent and treatment-refractory symptom clusters. Patients with these NPS are associated with increased risk of institutionalization, psychotropic medication use, caregiver burden, and mortality2.

Safe and effective treatments for NPS are lacking. Consensus guidelines emphasize the initial use of non-pharmacologic approaches though supportive evidence is limited3.

Extensive research has established the safety and efficacy of ECT in elderly patients with depression and other psychiatric conditions6. Clinical experience suggests that ECT is a valuable treatment option in MNCD-related treatment refractory NPS cases7-10. However, data supporting the efficacy and safety of this practice is scant.

Materials and Method:

Patients admitted to the geriatric psychiatry inpatient units who meet the inclusion criteria, were recruited from 2 Vancouver sites and 3 unit at Ontario Shores. These patients had an anesthesia consultation to evaluate their safety of going through ECT. Consent was obtained from their substitute decision makers. All patients enrolled are already on psychotropic medications.

Type
Abstract
Information
International Psychogeriatrics , Volume 32 , Issue S1 , October 2020 , pp. 58
Copyright
© International Psychogeriatric Association 2020