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ECT and Alzheimer
Amor Fati
Posted: Thursday, May 5, 2016 4:51 PM
Joined: 1/9/2016
Posts: 87

Do any of you have any experiences or knowledge about ECT and Alzheimer? We saw a new psychiatrist today and she recommended ECT for my husband's unrelenting crying and suicidal ideation unrelieved by medications. The limited research I did over the internet sounds promising. Any input from you smart folks would be greatly appreciated. Thank you.
Lane Simonian
Posted: Saturday, May 14, 2016 12:21 AM
Joined: 12/12/2011
Posts: 5108

I have not succeeded in finding anything conclusive about this type of therapy, but here is an interesting discussion about it.

Iris L.
Posted: Monday, May 16, 2016 2:03 PM
Joined: 12/15/2011
Posts: 18061

I just googled ECT treatment for Alzheimer's and there are many responses.  One made the distinction between ECT and deep brain stimulation.  I remember there was an extensive discussion on the old board in the Archives (pre 2011), and the general impression was against ECT for Alzheimer's disease.  Please check everything out before hand.

'Brain pacemaker' used to treat Alzheimer's

Friday November 25 2011

Electric pulses could potentially ease Alzheimer’s symptoms

Alzheimer’s disease could be eased by “the return of electric shock therapy”, the Daily Mailreported.

This story is based on a small safety trial that tested a technique called “deep brain stimulation” (DBS) in six patients withAlzheimer’s disease. The technique involves surgically implanting electrodes into the brain and delivering a series of mild electric pulses to the targeted brain region. However, although some patients showed slight improvements, the researchers’ objective was to test the safety of the technique, not whether it offered an effective treatment for Alzheimer’s. Therefore, they cannot confirm how DBS interacts with this complex disease or whether it does produce improvements.

The mild stimulation used in DBS is not to be confused with electroconvulsive therapy (ECT), or “shock therapy”, which is itself a valuable technique for helping some patients with severe depression. To explore their DBS technique further, the researchers are now conducting larger human trials and animal research, the results of which will show more clearly whether DBS could be used as a treatment.

read more: 

Iris L.

Amor Fati
Posted: Wednesday, May 18, 2016 10:58 AM
Joined: 1/9/2016
Posts: 87

Thank you for your replies.

Presently there is a pilot study in the planning stages by the Central Institute of Mental Health, Mannheim, Germany.  Under the purpose section of the proposed trial is the following information:

"...Many single studies, but also a number of meta-analyses show primary gray matter atrophy in hippocampal, parahippocampal and medial temporal brain regions. Strikingly, ECT yields exact opposite effects to those caused by AD: an ECT series leads to an increase of serum BDNF- levels in patients. Parallel to this observation evidence exists for gray matter volume gain after an ECT series, especially for the hippocampus. 

There is sufficient clinical experience regarding the use of ECT in AD- patients, mainly on the basis of following indications: a) affective disorders and b) behavioral disturbances. A positive effect of ECT on the symptoms of agitation and aggression was assessed in AD patients alongside with a very good tolerability. A recent review on ECT treatment in patients with concomitant depression and AD pointed out that these patients have significantly better scores in cognitive tests 6 months after the ECT series..." (emphasis added by me)

This proposed pilot study appears to be mostly interested in the effects of  ECT in cognitive treatment of AD patients, but it seems to say that ECT also has shown positive treatment results for depression in AD patients.

On a personal level, my sister received ECT treatment in the sixties for severe depression with suicidal ideation, unresponsive to oral medications. She did not have any adverse long term side effects, her depression never returned, she was able to complete her university studies and worked many years as a psychologist.

My husband has several comorbidities, among them seizure disorder and heart disease, which may exclude him from ECT treatments anyway. I hope to set up a telephone consultation with the ECT psychiatrist to discuss with him all the pros and cons of the Tx in the coming weeks. There is also an extensive workup prior to any treatments. And the final say will have my husband in all of this. I am just doing the information gathering.

Again, thank you for your replies. There appears to be an interest in the scientific community for the use of ECT in the treatment for AD patients.