Methohexitone, propofol and etomidate in electroconvulsive therapy for depression: a naturalistic comparison study.
AffiliationKing's College London, Institute of Psychiatry, London, UK.
Depressive Disorder, Major
MetadataShow full item record
CitationMethohexitone, propofol and etomidate in electroconvulsive therapy for depression: a naturalistic comparison study. 2009, 113 (1-2):165-71 J Affect Disord
JournalJournal of affective disorders
AbstractMethohexitone has been the most widely used anaesthetic for electroconvulsive therapy (ECT). However, recent scarcity and erratic availability has led to use of other anaesthetics with differing effects upon ECT. We compared treatment parameters and response to ECT in patients anaesthetised with different anaesthetics in a routine clinical setting.
This was a naturalistic retrospective casenote analysis of 81 consecutive courses of ECT (total 659 treatments) for major depression.
Three anaesthetics were compared: methohexitone (n=34), propofol (n=13) and etomidate (n=34). Mean seizure duration was lowest (p<0.0001) for propofol. However, mean stimulus charge was highest in the propofol group (p<0.0001) who required a greater increase in stimulus charge during the course of treatment and also experienced a greater proportion of failed seizures (
This was a retrospective casenote study, in which patients were not randomised to anaesthetic and standardised outcome measures were not used. The small sample size in the propofol group may have reduced the power of the study to demonstrate other differences between propofol and the other anaesthetic groups. A formal economic analysis was not performed.
Individual anaesthetics differentially influence seizure duration and stimulus charge but final response to ECT appears not to be adversely affected.
- Propofol and methohexital as anesthetic agents for electroconvulsive therapy: a randomized, double-blind comparison of electroconvulsive therapy seizure quality, therapeutic efficacy, and cognitive performance.
- Authors: Geretsegger C, Nickel M, Judendorfer B, Rochowanski E, Novak E, Aichhorn W
- Issue date: 2007 Dec
- A retrospective comparison of the effects of propofol and etomidate on stimulus variables and efficacy of electroconvulsive therapy in depressed inpatients.
- Authors: Graveland PE, Wierdsma AI, van den Broek WW, Birkenhäger TK
- Issue date: 2013 Aug 1
- Anesthesia and electroconvulsive therapy: a retrospective study comparing etomidate and propofol.
- Authors: Patel AS, Gorst-Unsworth C, Venn RM, Kelley K, Jacob Y
- Issue date: 2006 Sep
- The influence of anaesthetic medication on safety, tolerability and clinical effectiveness of electroconvulsive therapy.
- Authors: Eser D, Nothdurfter C, Schüle C, Damm J, Steng Y, Möller HJ, Rupprecht R, Baghai T
- Issue date: 2010 Mar
- A within-subject comparison of propofol and methohexital anesthesia for electroconvulsive therapy.
- Authors: Vaidya PV, Anderson EL, Bobb A, Pulia K, Jayaram G, Reti I
- Issue date: 2012 Mar