TITLE
Accelerated Intermittent Theta Burst Stimulation in Late-Life Depression: A Possible Option for Older Depressed Adults in Need of ECT During the COVID-19 Pandemic
SOURCE
American Journal of Geriatric Psychiatry. 28(10):1025-1029, 2020 10.
AUTHORS
Konstantinou GN; Downar J; Daskalakis ZJ; Blumberger DM. daniel.blumberger@camh.ca.
OBJECTIVE
Electroconvulsive therapy (ECT) is an essential psychiatric service with an important role in treating older adults with severe or treatment-resistant depression. During the COVID-19 pandemic, ECT services have be constrained by infection control measures. We report a case of a 66-year-old female patient with a severe major depressive episode who had previously responded to right unilateral ECT and was treated with two modified accelerated intermittent theta-burst stimulation (aiTBS) protocols.
METHODS
The two aiTBS courses consisted of eight daily sessions over five consecutive days, followed by gradual tapering, using 1,800 pulses per session pre-COVID-19 (first course), and 600 pulses per session during the pandemic (second course).
RESULTS
Moderate to severe baseline depressive symptoms reached remission levels after both courses.
CONCLUSION
The 600-pulses aiTBS treatment protocol reported here warrants further study and evaluation, but may be a potential option in cases where older adults with severe depressive symptoms cannot access ECT during the COVID-19 pandemic.
Copyright ? 2020 American Association for Geriatric Psychiatry.
