TY - JOUR
T1 - Right unilateral ultrabrief pulse ECT in geriatric depression
T2 - Phase 1 of the PRIDE study
AU - CORE/PRIDE Work Group
AU - Kellner, Charles H.
AU - Husain, Mustafa M.
AU - Knapp, Rebecca G.
AU - McCall, William Vaughn
AU - Petrides, Georgios
AU - Rudorfer, Matthew V.
AU - Young, Robert C.
AU - Sampson, Shirlene
AU - McClintock, Shawn M.
AU - Mueller, Martina
AU - Prudic, Joan
AU - Greenberg, Robert M.
AU - Weiner, Richard D.
AU - Bailine, Samuel H.
AU - Rosenquist, Peter B.
AU - Raza, Ahmad
AU - Kaliora, Styliani
AU - Latoussakis, Vassilios
AU - Tobias, Kristen G.
AU - Briggs, Mimi C.
AU - Liebman, Lauren S.
AU - Geduldig, Emma T.
AU - Teklehaimanot, Abeba A.
AU - Lisanby, Sarah H.
AU - Ahle, Gabriella
AU - Aloysi, Amy S.
AU - Bryson, Ethan
AU - Farber, Kate
AU - Majeske, Matthew
AU - Muller, Elizabeth
AU - Nazarian, Roya
AU - Pasculli, Rosa
AU - Cochran, Ashly
AU - Evans, Laura D.
AU - Friedman, David
AU - Kotbi, Nabil
AU - Lucas, Bryony
AU - Rogers, Arielle
AU - Gubosh, Brittany
AU - Hodges, Chelsea
AU - McCloud, Laryssa
AU - Riley, Mary Anne
AU - Braga, Raphael
AU - Fuentes, Ingrid
AU - Hiranpara, Ketan
AU - Khan, Muhammad
AU - Powers, Carmel
AU - Ray, Susan
AU - Reiter, Gail
AU - Youssef, Nagy Adel
N1 - Funding Information:
Supported by NIMH grants U01MH055495, U01MH081362, U01MH086127, U01MH086127, U01MH086130, U01MH08612005, U01MH084241, and U01MH086122.
PY - 2016/11/1
Y1 - 2016/11/1
N2 - Objective: The Prolonging Remission in Depressed Elderly (PRIDE) study evaluated the efficacy of right unilateral ultrabrief pulse electroconvulsive therapy (ECT) combined with venlafaxine for the treatment of geriatric depression. Method: PRIDE was a two-phase multisite study. Phase 1 was an acute course of right unilateral ultrabrief pulse ECT, combined with open-label venlafaxine at seven academic medical centers. In phase 2 (reported separately), patientswho had remitted were randomly assigned to receive pharmacotherapy (venlafaxine plus lithium) or pharmacotherapy plus continuation ECT. In phase 1, depressed patients received high-dose ECT (at six times the seizure threshold) three times per week. Venlafaxine was started during the first week of treatment and continued throughout the study. The primary outcome measure was remission, assessed with the 24-item Hamilton Depression Rating Scale (HAM-D), which was administered three times per week. Secondary outcome measures were post-ECT reorientation and safety. Paired t tests were used to estimate and evaluate the significance of change from baseline in HAM-D scores. Results: Of 240 patients who entered phase 1 of the study, 172 completed it. Overall, 61.7% (148/240) of all patients met remission criteria, 10.0% (24/240) did not remit, and 28.3% (68/ 240) dropped out; 70% (169/240)met response criteria. Among those who remitted, the mean decrease in HAM-D score was 24.7 points (95% CI=23.4, 25.9), with a mean final score of 6.2 (SD=2.5) and an average change from baseline of 79%. The mean number of ECT treatments to remission was 7.3 (SD=3.1). Conclusions: Right unilateral ultrabrief pulse ECT, combined with venlafaxine, is a rapidly acting and highly effective treatment option for depressed geriatric patients, with excellent safety and tolerability. These data add to the evidence base supporting the efficacy of ECT to treat severe depression in elderly patients.
AB - Objective: The Prolonging Remission in Depressed Elderly (PRIDE) study evaluated the efficacy of right unilateral ultrabrief pulse electroconvulsive therapy (ECT) combined with venlafaxine for the treatment of geriatric depression. Method: PRIDE was a two-phase multisite study. Phase 1 was an acute course of right unilateral ultrabrief pulse ECT, combined with open-label venlafaxine at seven academic medical centers. In phase 2 (reported separately), patientswho had remitted were randomly assigned to receive pharmacotherapy (venlafaxine plus lithium) or pharmacotherapy plus continuation ECT. In phase 1, depressed patients received high-dose ECT (at six times the seizure threshold) three times per week. Venlafaxine was started during the first week of treatment and continued throughout the study. The primary outcome measure was remission, assessed with the 24-item Hamilton Depression Rating Scale (HAM-D), which was administered three times per week. Secondary outcome measures were post-ECT reorientation and safety. Paired t tests were used to estimate and evaluate the significance of change from baseline in HAM-D scores. Results: Of 240 patients who entered phase 1 of the study, 172 completed it. Overall, 61.7% (148/240) of all patients met remission criteria, 10.0% (24/240) did not remit, and 28.3% (68/ 240) dropped out; 70% (169/240)met response criteria. Among those who remitted, the mean decrease in HAM-D score was 24.7 points (95% CI=23.4, 25.9), with a mean final score of 6.2 (SD=2.5) and an average change from baseline of 79%. The mean number of ECT treatments to remission was 7.3 (SD=3.1). Conclusions: Right unilateral ultrabrief pulse ECT, combined with venlafaxine, is a rapidly acting and highly effective treatment option for depressed geriatric patients, with excellent safety and tolerability. These data add to the evidence base supporting the efficacy of ECT to treat severe depression in elderly patients.
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U2 - 10.1176/appi.ajp.2016.15081101
DO - 10.1176/appi.ajp.2016.15081101
M3 - Article
C2 - 27418379
AN - SCOPUS:84994104663
SN - 0002-953X
VL - 173
SP - 1101
EP - 1109
JO - American Journal of Psychiatry
JF - American Journal of Psychiatry
IS - 11
ER -