Background : Electroconvulsive therapy (ECT) is often administered among the elderly, who are particularly likely to have concurrent medical conditions and medication intolerance. Objective : To examine the short‐and long‐term efficacy of ECT for late‐life depression, we performed a two‐phase, prospective, naturalistic follow‐up study that compared treatment outcome in old‐aged with that in middle‐aged subjects. Methods : Phase I study: Twenty‐one subjects who were consecutively referred for ECT, aged at least 50 years, and met the DSM‐IV criteria for a major depressive episode were enrolled. Before ECT, severity of concurrent medical conditions was assessed with the cumulative illness rating scale (CIRS). Before and after a course of ECT, the severity of depressive symptoms was evaluated with the 17‐item Hamilton rating scale for depression (HAM‐D). Phase II study: Seventeen subjects who responded to an acute ECT course in the phase I study were enrolled. Various continuation medications were administered, and symptoms were monitored and evaluated with the HAM‐D for 24 weeks or until relapse. Results : Overall the subjects had an 81 % short‐term response rate and a 47% relapse rate within 24 weeks after ECT. Response and relapse rates were not significantly different between the middle‐and old‐aged groups (response rates: 91% vs. 70%; relapse rates: 40% vs. 57%). However, the old‐aged patients had higher post‐ECT HAM‐D scores than the middle‐aged patients did (P<0.05), and CIRS scores positively correlated with post‐ECT HAM‐D scores (P<0.05). Relapsers tended to have higher CIRS scores than non‐relapsers did (P=0.06). Conclusion : In late‐life depression, the short‐term response rate to ECT is considerably good, but the relapse rate was relatively high. Clinicians need to take into consideration the age of patient and any concurrent medical conditions, when planning long‐term management of residual depressive symptoms and prevention of relapse after an initial good response to ECT. 相似文献
In this review I consider assays for G protein-coupled receptor (GPCR) activity based on the binding of labelled analogues of GTPγS ([35S]GTPγS or Eu-GTPγS) to G proteins in tissues (GTPγS binding assays). Such assays provide convenient measures of GPCR activity close to the receptor in the signalling cascade. In order to set up a GTPγS binding assay, the requirements of the assay must be considered. These are tissue source, GTPγS analogue, G protein, GDP, Mg2+/Na+ ions, saponin, incubation time. The assay, once optimized, can be used to generate concentration/response curves for GPCRs signalling via Gi/o proteins (or to other G proteins with a modified assay) and actions of agonists, inverse agonists and antagonists may, in principle, be assessed. For agonists and inverse agonists, data for the maximal agonist effect, the concentration of ligand giving a half-maximal response and the Hill coefficient may be derived. For antagonists, data for the equilibrium dissociation constant can be obtained. The mechanistic basis of the assay is considered. Although the assay can be used to profile ligands, under the conditions it is used, it may not be measuring the same event that determines GPCR action in cells. 相似文献