To the Editor.—
A letter by Kushnir1 testifies to the resolution of a depressive disorder in a 102-year-old woman by three drug trials and 40 days of treatment. It is unclear why the physician eschewed the use of electroconvulsive therapy in such a case when the first drug trial failed. The successful and safe use of electroconvulsive therapy in elderly depressed patients, including those with syndromes of pseudodementia, is well documented.2-6 The risks of repeated drug trials, and the use of new drug treatments with limited experience, does a disservice to elderly patients who often are more rapidly and more safely treated by modified electroconvulsive therapy than by antidepressant drugs.
Max Fink. The Diagnosis and Treatment of Depression in the Old. JAMA. 1988;260(10):1405. doi:10.1001/jama.1988.03410100095022