The Effects of Diltiazem on Hemodynamics and Seizure Duration During Electroconvulsive Therapy

Abstract

Diltiazem can blunt acute hyperdynamic responses after electroconvulsive therapy, but seizure duration is also significantly reduced, possibly making this therapy less effective.

Effects of Remifentanil on Convulsion Duration and Hemodynamic Responses During Electroconvulsive Therapy

“…21 In the current study, supplementation of thiopental with remifentanil leads to relative cardiovascular stability and was favorable in hemodynamic response. Systolic and diastolic BP was elevated after ECT, which was significantly higher in the thiopental group in respect to a combined anesthetic regimen.…”

Anesthetic Considerations for Electroconvulsive Therapy-Especially Hemodynamic and Respiratory Management

“…The hyperdynamic state induced by sympathetic activation can be prevented by ganglion-blockers [46], betablockers [47][48][49][50][51][52][53][54][55][56][57][58][59]67,77], alpha-1 and alpha2-agonists [60][61][62][63][64][65][66], Ca2+-channel antagonists [68][69][70], nitrates [71][72][73][74][75][76] or local anesthetics [78]. Rapid, short-acting opioid [79][80][81] analgesics also possess sympatholytic effects and have recently been investigated as adjuvants during ECT.…”

“…Wajima et al [70] examined the effects of 10 mg of diltiazem on hemodynamics and seizure duration provoked by ECT in a randomized fashion. Although diltiazem reduced the increases in HR and MAP after ECT compared with placebo (saline), the use of diltiazem shortened ECT-induced seizure duration.…”

The Effect of Remifentanil on Seizure Duration and Acute Hemodynamic Responses to Electroconvulsive Therapy

“…As a result of the cardiovascular morbidity associated with ECT (2,3), a wide variety of drugs have been administered in an effort to minimize the acute hemodynamic changes (2). Studies involving trimethaphan (4), nitroprusside (5), nitroglycerine (6), alfentanil (7), clonidine (8), 1 propranolol (9), 1 esmolol (10), labetalol (11)(12)(13), nicardipine (13), urapidil (14), dexmedetomidine (15), and diltiazem (16) have reported varying degrees of success in attenuating the acute hyperdynamic response associated with ECT.…”