An old man is diagnosed of having major depressive disorder. His son is telling that he always shows suicidal tendencies. What is the treatment of choice for depression with suicidal tendencies?

ECT is the most effective (about 70-85%) treatment of severe depression--paicularly the delusions and agitation commonly seen with depression in the elderly. It is indicated when medical conditions preclude the use of antidepressants, nonresponsiveness to these medications, and extreme suicidality.It is also effective in the manic disorders and psychoses during pregnancy (when medications may be contraindicated). Ref: Eisendrath S.J., Lichtmacher J.E. (2013). Chapter 25. Psychiatric Disorders. In M.A. Papadakis, S.J. McPhee, M.W. Rabow (Eds), CURRENT Medical Diagnosis & Treatment 2013.