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Cited by 269Electroconvulsive Therapy StudiesTreatment of Major DepressionTranscranial Magnetic Stimulation Studies

Right unilateral ultrabrief pulse ECT in geriatric depression: phase 1 of the pride study

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Kellner, Charles H., Husain, Mustafa M., Knapp, Rebecca G., McCall, W. Vaughn, Petrides, Georgios, Rudorfer, Matthew V., Young, Robert C., Sampson, Shirlene +17 more·2016·American Journal of Psychiatry
DOI 10.1176/appi.ajp.2016.15081101PMC PMC7130447
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Abstract

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), patients who 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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  • Patients over 70 years are 1.89 times more likely to respond to ECT than those 60-69 years old.

    “Their work also revealed that patients over 70 years are 1.89 times more to respond than those 60–69 years old.3”

    From Efficacious retrial of electroconvulsive therapy for major depressive disorder after a prolonged seizure in an older adult (2023) · cites this paper as [3]

    The Results (Predictors of Outcome) report that patients aged 70 or older had 1.89 times the odds of remission compared with those aged 60–69. The claim instead says patients over 70 were 1.89 times more likely to respond, changing the age cutoff, outcome, and odds measure. (LLM, conf=0.90)

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  • ECT has been shown to have great efficacy in the geriatric population, with the Prolonging Remission in Depressed Elderly Study enrolling 240 patients over age 60 and yielding a 70% response rate and 62% remission rate.

    “ECT has been shown to have great efficacy in the geriatric population as shown in the Prolonging Remission in Depressed Elderly Study, which enrolled 240 patients over the age of 60 years and yielded a 70% response rate and 62% remission rate.”

    From Efficacious retrial of electroconvulsive therapy for major depressive disorder after a prolonged seizure in an older adult (2023) · cites this paper as [3]

  • The mean number of ECT treatments to achieve remission was 7.3 (SD = 3.1).

    “The mean number of ECT treatments to achieve remission was 7.3 (SD = 3.1).”

    From Mechanisms and treatment of late-life depression (2019) · cites this paper as [159]

  • Right unilateral ultrabrief pulse ECT, combined with venlafaxine led to remission in 61.7% and to response in 70% of patient with late-life major depression and was well tolerated.

    “Nonetheless, right unilateral ultrabrief pulse ECT, combined with venlafaxine led to remission in 61.7% and to response in 70% of patient with late-life major depression and was well tolerated159.”

    From Mechanisms and treatment of late-life depression (2019) · cites this paper as [159]

  • In remitted patients, adding four ECT treatments over 1 month to continuation treatment with venlafaxine and lithium led to better 24-month outcomes than venlafaxine and lithium alone.

    “In remitted patients, adding four ECT treatments over 1 month to continuation treatment with venlafaxine and lithium led to better 24-month outcomes than venlafaxine and lithium alone159.”

    From Mechanisms and treatment of late-life depression (2019) · cites this paper as [159]

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Authors
Kellner, C. H., Husain, M. M., Knapp, R. G., McCall, W. V., Petrides, G., Rudorfer, M. V., Young, R. C., Sampson, S., McClintock, S. M., Mueller, M., Prudic, J., Greenberg, R. M., Weiner, R. D., Bailine, S. H., Rosenquist, P. B., Raza, A., Kaliora, S., Latoussakis, V., Tobias, K. G., Briggs, M. C., Liebman, L. S., Geduldig, E. T., Teklehaimanot, A. A., Lisanby, S. H., & the CORE/PRIDE Work Group
Affiliations
Lutheran Medical Center (US)
ORCID
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
2016-11
Volume
173
Issue
11
Pages
1101-1109
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/appi.ajp.2016.15081101
PMC
PMC7130447
OpenAlex
W2467695657
Cited by
269
References
42
Citations by year
2026: 17 · 2025: 13 · 2024: 33 · 2023: 16 · 2022: 24 · 2021: 28 · 2020: 32 · 2019: 45 · 2018: 35 · 2017: 20 · 2016: 6
FWCI
31.39
Type
journal article
Language
en
Open access
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (U01MH055495, U01MH086122, U01MH084241, U01MH081362, U01MH086130, K02MH067028, U01MH086127)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
Keywords
right unilateral ECT, geriatric depression, venlafaxine, antidepressant combination therapy, depression remission, elderly patients, PRIDE study
MeSH terms
Venlafaxine Hydrochloride, Aged, Aged, 80 and over, Combined Modality Therapy, Depression, Electroconvulsive Therapy, Female, Humans, Male, Middle Aged, Treatment Outcome, Antidepressive Agents, Second-Generation

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