Elec­tro­con­vul­sive ther­apy to com­bat the blues of age?

China Daily (Hong Kong) - - HEALTH - By JAMES LE FANU

“Melan­choly is a nec­es­sary and in­escapable ac­com­pa­ni­ment of an old per­son,” ob­served Robert Bur­ton in his fa­mous 17 th-cen­tury trea­tise, The Anatomy of Melan­choly. “Af­ter 70 years, all is trou­ble and sor­row.”

But no longer. The bus-pass gen­er­a­tion is, if any­thing, more cheer­ful than their off­spring — grate­ful, per­haps, that life has turned out so much bet­ter than might have been ex­pected.

Still, it would be sur­pris­ing if the in­escapable re­al­i­ties of get­ting on and the losses associated with it did not dampen the spirit, and “af­ter 70 years” around one in 10 are af­fected by the blues of suf­fi­cient in­ten­sity to war­rant an­tide­pres­sants.

These can be of value in about a third of those to whom they are pre­scribed, but it is not un­usual to en­counter those who have been tak­ing them for sev­eral years to lit­tle ef­fect, other than a med­ley of side­ef­fects.

It is thus of con­sid­er­able in­ter­est that a mod­i­fied ver­sion of the much frowned on elec­tro­con­vul­sive ther­apy (first in­tro­duced 80 years ago) should be found to “in­duce a rapid and ro­bust im­prove­ment” in just over a fort­night in those who have not re­sponded to med­i­ca­tion.

This ul­tra-brief pulse ECT, as it is known, de­liv­ers half the pre­vi­ous elec­tri­cal dose and is thus less likely to cause the con­fu­sion and short­term mem­ory loss associated with stan­dard ther­apy.

This might sound al­most too good to be true, but those who wish to know more will find a sum­mary of re­cent stud­ies by Googling “McKnight, Kell­ner, Pride, clin­i­cal psy­chi­a­try”.

Com­mu­ni­ca­tion co­nun­drum

The co­nun­drum of the lady falsely ac­cused of be­ing drunk — on more than one oc­ca­sion — be­cause of her slurred speech when talk­ing on the phone has prompted a bevvy of cor­re­spon­dence. The prob­lem was most no­tice­able when she was fa­tigued but, as noted, her ENT spe­cial­ist had found noth­ing amiss, such as nod­ules or swelling of the vo­cal cords.

The link with fa­tigue sug­gests that it could be the pre­mon­i­tory symp­tom of a neu­ro­log­i­cal con­di­tion such as Parkin­son’s — even in the ab­sence of the usual, more prom­i­nent symp­toms — which should re­spond to treat­ment with Levodopa.

It might also in­di­cate myas­the­nia gravis, a rare neu­ro­mus­cu­lar dis­ease that causes weak­ness in the skele­tal mus­cles.

One reader of­fers an­other the­ory. “The vicar came to the al­tar one Easter morn­ing, threw wide his arms and pro­claimed ‘Chrisht ish rishen!’ I was hor­ri­fied. Alas, it was not drink, but the first sign of mo­tor neu­rone dis­ease.”

The two other pos­si­bil­i­ties that should be con­sid­ered are an un­der­ac­tive thy­roid and rheuma­toid arthri­tis, which can some­times just af­fect the joints around the lar­ynx.

What­ever it turns out to be, re­tired speech and lan­guage ther­a­pist Rita Twis­ton Davies urges that she con­tact the Royal Col­lege (rc­slt.org) to find a prac­ti­tioner in her area, who “should cer­tainly be able to elu­ci­date why she is hav­ing these com­mu­ni­ca­tion prob­lems at her age”.

I stopped drink­ing the ... grape­fruit juice I have every morn­ing ... and my wrist symp­toms im­proved im­me­di­ately.” Ox­ford lady trou­bled by arthri­tis in her right wrist

What the juice

Fi­nally, it is al­ways grat­i­fy­ing to hear from those who have ben­e­fited from re­cent items in this col­umn.

“It was a light-bulb mo­ment,” writes an Ox­ford lady trou­bled by arthri­tis in her right wrist when read­ing of the gar­dener on a pri­vate es­tate whose arthritic pains in his right hand (pre­vi­ously at­trib­uted to over-use of his se­ca­teurs) re­solved when he gave up orange juice.

“I stopped drink­ing the glass of grape­fruit juice I have every morn­ing as the first of my five-a-day — and my wrist symp­toms im­proved im­me­di­ately.”

Email med­i­cal ques­tions con­fi­den­tially to Dr James Le Fanu at dr­james@tele­graph.co.uk

PRO­VIDED TO CHINA DAILY

An­tide­pres­sants such as Prozac can be of value in about a third of peo­ple who take them.

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