Electroconvulsive Therapy use in a 97-Year-Old Woman

OBJECTIVES: The aim of this paper is to report the use of electroconvulsive therapy (ECT) to successfully treat depression in a 97-year-old woman, and to discuss the safety and efficacy of ECT in the very old. METHODS: A case report and review of the literature on the use of ECT to treat depression in the very old is presented. RESULTS: The subject recovered fully from her depression but suffered a serious adverse event (fractured femur) during the course of ECT. Relatively few publications on the use of ECT in the very old were found. The majority of articles concerned patients aged between 65 and 85, with one study including patients up to age 96. CONCLUSIONS: There appears to be an absence of randomized clinical trial evidence to support the use of ECT as a treatment for depression in the very old. Based on the limited evidence from case reports and case series, the indications appear to be the same as for younger patients. There do not appear to be any absolute contraindications, and ECT appears to be a safe and efficacious treatment for depression in the very old. However, in the light of our subject's serious adverse event, there may be a need to consider additional safety precautions in the very old. Finally, we believe our patient is the oldest person reported to be successfully treated with suprathreshold ECT.