The influence of anaesthetic medication on safety, tolerability and clinical effectiveness of electroconvulsive therapy

Eser, Daniela; Schüle, Cornelius; Damm, Julia; Steng, Yvonne; Möller, Hans‐Jürgen; Rupprecht, Rainer; Baghai, Thomas C.

doi:10.1080/15622970902960897

Cited by 12 publications

(9 citation statements)

References 37 publications

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“…Also, Dew et al showed that shorter seizures were observed with thiopental sodium, which is not consistent with the present study [25]. But Eser and colleagues showed that Thiopental Sodium produced longer seizures than propofol, and also indicated that thiopental sodium and propofol were more effective than other anesthetic drugs in relation to their clinical effects in ECT [2], which is consistent with the results of this study. Regarding the controversial results, it seems that supplementary studies with the comparison of propofol, thiopental sodium and succinylcholine on the duration, quality and severity of seizure following ECT seem necessary.…”

Section: Discussionsupporting

confidence: 58%

“…Electrotherapy or electroconvulsive therapy (ECT) is an effective strategy in the treatment of various types of psychiatric disorders [1,2]. ECT is one of the oldest treatments for mental illness [3] and is also a preferred method among all these modern treatments [4].…”

Section: Introductionmentioning

confidence: 99%

“…In a study on the duration of seizures in 62 patients undergoing ECT, Bauer and colleagues concluded that the duration of seizures in the thiopental group was shorter than that of propofol [36]. Eser and colleagues emphasized during their study that Thiopental Sodium produced longer seizures than propofol, and also indicated that thiopental sodium and propofol were more effective than other anesthetic drugs in their ECT clinical effects [2]. Japanese researchers also showed that the duration of seizure in the propofol group is lower than thiopental sodium [37].…”

Section: Introductionmentioning

confidence: 99%

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The Comparison of the Effect of Repetitive Doses of Succinylcholine and Thiopental Sodium on the Duration and Severity of Seizure in Electro Convulsive Therapy: Randomized Clinical Trial

Nanaei

Bahrami

Kasani

2019

JPRI

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Background and Aim: Regarding the controversial results on the effects of anesthetics, especially thiopental sodium, on the duration and severity of seizure and the lack of adequate information on the use of doses of anesthetic and paralysing drugs during ECT, this study was designed to determine the effect of repetitive doses of succinylcholine and Thiopental sodium was administered on the duration and severity of seizure during ECT. Materials and Methods: The present study was a one-blind randomized clinical trial on patients admitted to the psychiatric ward of Dezful Ganjavian Hospital. The research samples were selected after informed consent and entry criteria. Then, the samples were randomly assigned to two groups. In one group, succinylcholine dose was repeated (one third of the initial dose), and in the other group, the dose of thiopental sodium was repeated (one third of the initial dose). In all patients, seizure duration based on EEG monitoring and severity of seizure was determined by the psychiatrist based on the symptoms of the patient during seizure. Results: There was a significant difference between the quality of seizure in the two treatment groups after the intervention. There was a strong and good seizure in the thiopental sodium group (p <0.0001). There was a significant difference between the variables of seizure status in comparison with the previous shock in the two treatment groups after the intervention (p <0.0001). The duration of seizure was higher in thiopental sodium treatment group, but no significant difference was observed (p = 0.82). Conclusion: The results of this study showed that the duration and quality of seizure was better in patients requiring repetitive doses of hypnotic drugs (Thiopental Sodium), which was used to repeat the dose of muscle relaxant (succinylcholine).

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Section: Discussionsupporting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Comparison of the Effect of Repetitive Doses of Succinylcholine and Thiopental Sodium on the Duration and Severity of Seizure in Electro Convulsive Therapy: Randomized Clinical Trial

Nanaei

Bahrami

Kasani

2019

JPRI

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“…Our study aimed to demonstrate differences among these three agents. A retrospective study by Eser et al18 compared these anesthetics’ effects in ECT, but it included also patients anesthetized with methohexital. The authors concluded that thiopental and propofol are the most suitable induction agents during ECT.…”

Section: Discussionmentioning

confidence: 99%

Comparison of anesthetics in electroconvulsive therapy: an effective treatment with the use of propofol, etomidate, and thiopental

Zahavi¹,

Dannon²

2014

NDT

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ObjectivesElectroconvulsive therapy (ECT) is considered to be one of the most effective treatments in psychiatry. Currently, three medications for anesthesia are used routinely during ECT: propofol, etomidate, and thiopental. The objective of this study was to evaluate the effects of the anesthetics used in ECT on seizure threshold and duration, hemodynamics, recovery from ECT, and immediate side effects.MethodsOur study is a retrospective cohort study, in which a comparison was made between three groups of patients who underwent ECT and were anesthetized with propofol, etomidate, or thiopental. The main effect compared was treatment dose and seizure duration. All patients were chosen as responders to ECT.ResultsData were gathered about 91 patients (39 were anesthetized with thiopental, 29 with etomidate, and 23 with propofol). Patients in the thiopental group received a lower electrical dose compared to the propofol and etomidate group (mean of 459 mC compared to 807 mC and 701 mC, respectively, P<0.001). Motor seizure duration was longer in the thiopental group compared to propofol and etomidate (mean of 40 seconds compared to 21 seconds and 23 seconds, respectively, P=0.018). Seizure duration recorded by electroencephalography was similar in the thiopental and etomidate groups and lower in the propofol group (mean of 57 seconds in both groups compared to 45 seconds, respectively, P=0.038).ConclusionPatients who were anesthetized with thiopental received a lower electrical treatment dose without an unwanted decrease in seizure duration. Thiopental might be the anesthetic of choice when it is congruent with other medical considerations.

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“…Disadvantages include hypertension and occasional transient dissociative symptoms on wake up. 17 , 19 , 21 A recent systematic review concluded that robust evidence to recommend a particular induction agent for ECT is lacking and indicated that anesthetic agents should be chosen on the basis of adverse effect profile, emergence, and how these medications affect seizure duration. 18 Opioids, such as remifentanil and alfentanil, combined with anesthetic agents have been used to increase the seizure duration by an induction agent dose-sparing effect.…”

Section: Medications During the Ect Proceduresmentioning

confidence: 99%

Medication management during electroconvulsant therapy

Zolezzi¹

2016

NDT

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Electroconvulsive therapy (ECT) has demonstrated to be highly effective and safe, even life saving for many psychiatric disorders such as major depression, bipolar disorder and schizophrenia. Most patients who require ECT are also on concurrent pharmacotherapy. As such, the objective of this article is to provide a review of the most recent literature focusing on the medications used during an ECT procedure and on the effects of concurrent psychiatric and non-psychiatric medications on the effectiveness and safety of ECT. The review also attempts to summarize the recommendations derived from existing documents to guide pharmacotherapy decisions for patients undergoing ECT. For this purpose, using electronic databases, an extensive search of the current literature was made using ECT and medications or drug classes as keywords.

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The influence of anaesthetic medication on safety, tolerability and clinical effectiveness of electroconvulsive therapy

Cited by 12 publications

References 37 publications

The Comparison of the Effect of Repetitive Doses of Succinylcholine and Thiopental Sodium on the Duration and Severity of Seizure in Electro Convulsive Therapy: Randomized Clinical Trial

The Comparison of the Effect of Repetitive Doses of Succinylcholine and Thiopental Sodium on the Duration and Severity of Seizure in Electro Convulsive Therapy: Randomized Clinical Trial

Comparison of anesthetics in electroconvulsive therapy: an effective treatment with the use of propofol, etomidate, and thiopental

Medication management during electroconvulsant therapy

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