Cognitive impairment and electroconvulsive therapy in geriatric depression, what could be the role of rivastigmine? A case series

  • Audrey Monica van Schaik | au.vanschaik@ggzingeest.nl GGZ inGeest, Amsterdam, Netherlands.
  • Didi Rhebergen GGZ inGeest, Amsterdam; Department of Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, Netherlands.
  • Marieke Jantien Henstra Department of Internal Medicine, Section of Geriatric Medicine, VU University Medical Center, Amsterdam, Netherlands.
  • Daniel J. Kadouch Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands.
  • Eric van Exel Department of Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, Netherlands.
  • Maximilianus Lourentius Stek Department of Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, Netherlands.

Abstract

Electroconvulsive therapy (ECT), albeit highly effective in treating depression, is frequently associated with cognitive impairment, either temporary or more persistent. Especially in older patients, who generally respond even better, serious cognitive impairment during the course of ECT may lead to premature termination of ECT. Treatment of this cognitive impairment is of utmost importance. In this case series report, we present the effect of rivastigmine, an acetylcholinesterase inhibitor, on cognitive impairment in three older, severely depressed patients during or after a course of ECT. An improvement of cognitive functioning, in particular a decline of confusional symptoms, was observed in two patients with structural brain alterations associated with aging. In the other patient, who suffered primarily from amnesia, no effect of rivastigmine was observed. These preliminary results emphasize the need for detailed profiling of cognitive impairment when developing a research design to study the potential benefits of rivastigmine in the prevention or treatment of cognitive impairment in severely depressed patients treated with ECT.

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Published
2015-09-28
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Section
Case Reports
Keywords:
Depression, cognitive impairment, electroconvulsive therapy, elderly, acetylcholinesterase inhibitor, rivastigmine.
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How to Cite
van Schaik, A. M., Rhebergen, D., Henstra, M. J., Kadouch, D. J., van Exel, E., & Stek, M. L. (2015). Cognitive impairment and electroconvulsive therapy in geriatric depression, what could be the role of rivastigmine? A case series. Clinics and Practice, 5(3). https://doi.org/10.4081/cp.2015.780