Etomidate improves seizure adequacy during electroconvulsive therapy

Psychiatry Res. 2019 Mar:273:350-354. doi: 10.1016/j.psychres.2019.01.065. Epub 2019 Jan 17.

Abstract

The purpose of this study was to assess whether switching propofol to etomidate during an electroconvulsive therapy course improves seizure quality in convulsion-resistant patients. A retrospective study of paired cases included thirty-three patients. Seizure variables for each agent were assessed. A generalized linear mixed model (GLMM) for repeated measures was used for the analysis. Anesthesia with etomidate leads to greater seizure duration, improved seizure quality in the EEG register, and prevents further need for restimulation; although did not differ from propofol in the amount of energy delivered or in other automated parameters. These results suggest that this procedure appears to be an adequate strategy to improve seizure quality.

Keywords: High seizure threshold; Propofol; Restimulation.

MeSH terms

  • Adult
  • Anesthetics, Intravenous / therapeutic use
  • Drug Substitution / methods
  • Electroconvulsive Therapy / methods*
  • Electroconvulsive Therapy / standards
  • Electroencephalography
  • Etomidate / therapeutic use*
  • Female
  • Humans
  • Hypnotics and Sedatives / therapeutic use*
  • Male
  • Middle Aged
  • Propofol / therapeutic use
  • Retrospective Studies
  • Seizures / diagnosis*
  • Seizures / therapy*

Substances

  • Anesthetics, Intravenous
  • Hypnotics and Sedatives
  • Propofol
  • Etomidate