Symptoms and treatment of agitated depression;pharmacotherapy and electroconvulsive therapy

Satoshi Ueda

Tokyo Satsuki Psychiatric Hospital

Among late-life depression, the most intractable clinically is agitated depression, which often gives patients more pain than other types of depression.　Antidepressants are rarely effective for agitated depression, and atypical antipsychotics and/or mood stabilizer are needed for the treatment.　When these agents are not enough to treat patients, electroconvulsive therapy（ECT） should be used.　It is often harder to induce sufficient seizure in ECT for very old patients.　To prevent from this, seizure evaluation on ictal EEG following each ECT session is essential.　Moreover, right unilateral electrode placement instead of bilateral is strongly recommended to induce stable seizure and reduce cognitive impairment.

Address correspondence to Dr. Satoshi Ueda, Tokyo Satsuki Psychiatric Hospital（2-27-1 Higashitsutsujigaoka, Chofu-shi, Tokyo 182-0005, Japan）