Antihypertensive medications and ECT

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Prominent changes in hemodynamics occur during electroconvulsive therapy (ECT) despite general anesthesia and muscle relaxation and regardless of choice of stimulating electrode placement. The most common pattern is hypertension and tachycardia during the seizure, followed by relative bradycardia and a gradual return of blood pressure to normal within minutes of the end of the seizure. The mortal and morbid risk of these changes is generally small; nevertheless, it is common practice to administer antihypertensive medications to blunt this response. Several agents have proven able to reduce ECT-related hypertension and tachycardia; however, it is unknown whether these agents reduce mortality or cardiovascular morbidity or alter efficacy or cognitive effects of ECT. A few case reports suggest intravenous antihypertensives may be positively dangerous on occasion. Based upon these findings, antihypertensives need not be given routinely during ECT, and when given, conservative doses should be used. The short-acting beta blockers may be particularly suited to this task. To prevent needless use of these agents and the possibility of an adverse event, the patient's intravascular volume, blood pressure and pulse should be optimized prior to the first ECT.

Original languageEnglish (US)
Pages (from-to)317-325
Number of pages9
JournalConvulsive Therapy
Volume9
Issue number4
StatePublished - Dec 1 1993

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Electroconvulsive Therapy
Antihypertensive Agents
Tachycardia
Seizures
Blood Pressure
Hypertension
Muscle Relaxation
Bradycardia
General Anesthesia
Electrodes
Hemodynamics
Morbidity
Mortality

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Antihypertensive medications and ECT. / McCall, W. V.

In: Convulsive Therapy, Vol. 9, No. 4, 01.12.1993, p. 317-325.

Research output: Contribution to journalArticle

McCall, W. V. / Antihypertensive medications and ECT. In: Convulsive Therapy. 1993 ; Vol. 9, No. 4. pp. 317-325.
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