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The influence of anaesthetic medication on safety, tolerability and clinical effectiveness of electroconvulsive therapy.
World J Biol Psychiatry. 2010 Mar; 11(2 Pt 2):447-56.WJ

Abstract

BACKGROUND

Electroconvulsive therapy (ECT) is still considered the most effective biological treatment strategy in psychiatric disorders. However, the clinical efficacy of ECT may be affected by stimulus variables and the concomitant use of psychopharmacological medication. Furthermore, most anaesthetics have anticonvulsant properties and therefore might additionally influence the efficacy of ECT.

METHOD

In order to explore whether different anaesthetics might alter the effectiveness or safety of ECT we retrospectively analyzed 5482 ECT treatments in 455 patients. Anaesthetics were chosen according to clinical reasons and comprised thiopental, methohexital, propofol and etomidate.

RESULTS

Seizure duration was significantly affected by the anaesthetic medication with longest seizure activity during thiopental anaesthesia. In addition, postictal suppression, a further prospective parameter of ECT effectiveness, was significantly higher during propofol and thiopental anaesthesia. The clinical effectiveness was significantly better during propofol and thiopental anaesthesia. In contrast, the overall safety did not differ between the anaesthetic groups.

CONCLUSION

Our study supports the hypothesis that inducting anaesthetic agents have a different impact on seizure duration, ictal and postictal electrophysiological indices and clinical efficacy of ECT. Compared to thiopental, which has been established as a standard anaesthetic during ECT, also the modern anaesthetic propofol is a suitable inducting agent.

Authors+Show Affiliations

Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany. Daniela.Eser@med.uni-muenchen.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19462341

Citation

Eser, Daniela, et al. "The Influence of Anaesthetic Medication On Safety, Tolerability and Clinical Effectiveness of Electroconvulsive Therapy." The World Journal of Biological Psychiatry : the Official Journal of the World Federation of Societies of Biological Psychiatry, vol. 11, no. 2 Pt 2, 2010, pp. 447-56.
Eser D, Nothdurfter C, Schüle C, et al. The influence of anaesthetic medication on safety, tolerability and clinical effectiveness of electroconvulsive therapy. World J Biol Psychiatry. 2010;11(2 Pt 2):447-56.
Eser, D., Nothdurfter, C., Schüle, C., Damm, J., Steng, Y., Möller, H. J., Rupprecht, R., & Baghai, T. (2010). The influence of anaesthetic medication on safety, tolerability and clinical effectiveness of electroconvulsive therapy. The World Journal of Biological Psychiatry : the Official Journal of the World Federation of Societies of Biological Psychiatry, 11(2 Pt 2), 447-56. https://doi.org/10.1080/15622970902960897
Eser D, et al. The Influence of Anaesthetic Medication On Safety, Tolerability and Clinical Effectiveness of Electroconvulsive Therapy. World J Biol Psychiatry. 2010;11(2 Pt 2):447-56. PubMed PMID: 19462341.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The influence of anaesthetic medication on safety, tolerability and clinical effectiveness of electroconvulsive therapy. AU - Eser,Daniela, AU - Nothdurfter,Caroline, AU - Schüle,Cornelius, AU - Damm,Julia, AU - Steng,Yvonne, AU - Möller,Hans-Jürgen, AU - Rupprecht,Rainer, AU - Baghai,Thomas, PY - 2009/5/23/entrez PY - 2009/5/23/pubmed PY - 2010/6/15/medline SP - 447 EP - 56 JF - The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry JO - World J Biol Psychiatry VL - 11 IS - 2 Pt 2 N2 - BACKGROUND: Electroconvulsive therapy (ECT) is still considered the most effective biological treatment strategy in psychiatric disorders. However, the clinical efficacy of ECT may be affected by stimulus variables and the concomitant use of psychopharmacological medication. Furthermore, most anaesthetics have anticonvulsant properties and therefore might additionally influence the efficacy of ECT. METHOD: In order to explore whether different anaesthetics might alter the effectiveness or safety of ECT we retrospectively analyzed 5482 ECT treatments in 455 patients. Anaesthetics were chosen according to clinical reasons and comprised thiopental, methohexital, propofol and etomidate. RESULTS: Seizure duration was significantly affected by the anaesthetic medication with longest seizure activity during thiopental anaesthesia. In addition, postictal suppression, a further prospective parameter of ECT effectiveness, was significantly higher during propofol and thiopental anaesthesia. The clinical effectiveness was significantly better during propofol and thiopental anaesthesia. In contrast, the overall safety did not differ between the anaesthetic groups. CONCLUSION: Our study supports the hypothesis that inducting anaesthetic agents have a different impact on seizure duration, ictal and postictal electrophysiological indices and clinical efficacy of ECT. Compared to thiopental, which has been established as a standard anaesthetic during ECT, also the modern anaesthetic propofol is a suitable inducting agent. SN - 1814-1412 UR - https://www.unboundmedicine.com/medline/citation/19462341/The_influence_of_anaesthetic_medication_on_safety_tolerability_and_clinical_effectiveness_of_electroconvulsive_therapy_ DB - PRIME DP - Unbound Medicine ER -