Electroconvulsive therapy in the elderly

Electroconvulsive therapy (ECT) involves the induction of a generalized tonic-clonic seizure by means of an electric current applied to the head of the patient. The procedure is performed under general anesthesia with the use of muscle relaxants. The efficacy and safety of ECT has been controversial since the introduction of this treatment in the 1930s. Today, ECT is considered to be a safe and effective therapeutic option in treating a number of psychiatric illnesses. With recent technical advances, ECT has fewer adverse results, is safer even in the very old and is effective for a widel range of indications. Nevertheless, many physicians remain hesitant to refer their patients for ECT because of the mistaken belief that this form of treatment is primitive and barbaric. In this article we review the use of ECT in the elderly.