A five-year retrospective study investigating the effects of psychotropic medication on first seizure length was undertaken on 109 patients who received 131 courses of electroconvulsive therapy (ECT). Bilateral ECT was administered under methohexitone anaesthesia. Induction of a seizure was successful in 105 patients. Stepwise linear regression analysis showed that except for selective serotonin reuptake inhibitors (SSRIs) seizure length was not affected by psychotropic medication, SSRIs were associated with prolonged seizure length (p=0.0012). Less than one-third of the subjects had drugs with anticonvulsant properties omitted before treatment. Drugs with anticonvulsant properties did not shorten seizure length. Though this study suggests that SSRIs may prolong fit length, further clarification of the predictors for seizure duration is required.
Altman D.J. (1991) Practical statistics for medical research. Chapman & Hall, London, pp. 340-343
2.
American Psychiatric Association (1978) Electroconvulsive therapy. Report of the task force on electroconvulsive therapy of the American Psychiatric Association . American Psychiatric Association,Washington, DC
3.
American Psychiatric Association (1990) The practice of electroconvulsive therapy: Recommendations for treatment, training and privileging. American Psychiatric Association,Washington, DC
4.
Anathanasios P. (1992) Acute administration of fluoxetine and the duration of electrically induced seizures. Convul Therap8: 38-39
5.
Brennan F.N., Lyttle J.A. (1987) Alcohol and seizures: a review. J Roy Soc Med80: 571-573
6.
Byrne P.O., Farquharson R.G., Schofield I.S. (1995) The pitfalls of dose titration as used in electroconvulsive therapy. Psychiatr Bull19: 207-208
7.
Cantor C. (1986) Carbamazepine and ECT: a paradoxical combination . J Clin Psychiatr47: 276-277
8.
Caracci G., Decina P. (1991) Fluoxetine and prolonged seizures. Convul Therap7:145-147
9.
Cohen S.I., Lawton C. (1992) Do benzodiazepines interfere with the action of electroconvulsive therapy. Br J Psychiatr160: 545-546
10.
Cooper G.L. (1988) The safety of fluoxetine, an update. Br J Psychiatr153 (Suppl. 3): 77-86
11.
Curran S. (1995) Effect of paroxetine on seizure length during electroconvulsive therapy. Acta Psychiatr Scand92: 239-240
12.
Deahl M., Trimble M. (1991) Serotonin reuptake inhibitors, epilepsy and myoclonus . Br J Psychiatr159: 433-435
13.
d'Elia G (1982) Benzodiazepines and effectiveness of ECT. Br J Psychiatr140: 322-323
14.
Fear C.F., Littlejohns C.S., Rouse E., McQuail P. (1994) Propofol anaesthesia in electroconvulsive therapy. Reduced seizure duration may not be relevant. Br J Psychiatr165: 506-509
15.
Freinhar J.P., Alvarez W.A. (1986) Clonazepam treatment of organic brain syndromes in three elderly patients. J Clin Psychiatr47: 525-526
16.
Gassy J.E., Rey J.M. (1990) A survey of ECT in a general hospital psychiatry unit. Austr NZ J Psychiatr24: 385-390
17.
Gran L., Bergsholm P., Bleie H. (1984) Seizure duration in unilateral electroconvulsive therapy; A comparison of the anaesthetic agent ethomidate and Althesin with methohexitone. Acta Psychiatr Scand69: 472-483
18.
Green M.A. (1960) Relation between threshold and duration of seizures and electrographic change during therapy. J Nerv Ment Dis131:117-120
19.
Gutierrez-Esteinou R., Pope H.G. (1989) Does fluoxetine prolong electrically induced seizures ? Convuls Therap5:344-348
20.
Haller E., Binder L. (1990) Clozapine and seizures. Am J Psychiatr147:1069-1071
21.
Hargrave R., Martinez D., Bernstein A.J. (1992) Fluoxetine induced seizures. Psychosomatics33: 236-269
Holmberg G. (1955) The effect of certain factors on the convulsions in electric shock treatment. Acta Psychiatr Scand98(Suppl): 1-19
24.
Julius S.C., Brenner R.P. (1987) Myoclonic seizures with lithium. Biol Psychiatr22:1184-1190
25.
Kellner C.H., Bruno R.M. (1989) Fluoxetine and ECT. Convul Therap5: 367-368
26.
Kendell R.E. (1981) The present status of electroconvulsive therapy . Br J Psychiatr139: 265-283
27.
King P.H., Shin C., Mansbach H.H., Chen L.S., McNamara J.O. (1987) Micro injection of a benzodiazepine into substantia nigra elevates kindled seizure threshold. Brain Res423: 261-268
28.
Kramer B.A. (1983) Seizure parameters in depressed patients receiving electroconvulsive therapy: a pilot study. Comp Psychiatr24: 259-261
29.
Lejoyeaux M., Rouillon F., Ades J., Gorwood P. (1992) Neural symptoms induced by tricyclic antidepressants. Phenomenology and pathophysiology. Acta Psychiatr Scand85: 249-256
30.
Loscher W., Nolting B. (1991) The role of technical, biological and pharmacological factors in the laboratory evaluation of anticonvulsant drugs. IV Protective indices. Epilepsy Res9: 1-10
31.
Loscher W., Rundfeldt C., Honack D. (1993) Pharmacological characterisation of phenytoin resistant amygdala-kindled rats, a new model of drug resistant partial epilepsy. Epilepsy Res15: 207-219
32.
Maletzky B.M. (1978) Seizure duration and clinical effect in electroconvulsive therapy. Comp Psychiatr19: 541-555
33.
Markowitz J.C., Brown R.P. (1987) Seizures with neuroleptics and antidepressants . Gen Hosp Psychiatr9:135-141
34.
McCreadie R.G., Phillips K., Robinson A D T, Gilhooly G., Crombie W. (1989) Is electroencephalographic monitoring of electroconvulsive therapy clinically useful. Br J Psychiatr154: 229-231
35.
Ng S.K., Hauser W.A., Brust J.C., Susser M. (1988) Alcohol consumption and withdrawal in new onset seizures. New Engl J Med319: 666-673
36.
Olesen A.C., Lolk A., Christensen P. (1989) Effect of a single nighttime dose of Oxazepam on seizure duration in electroconvulsive therapy. Convul Therap5: 3-7
37.
Pettinatti H.M., Stephens S.M., Willis K.M., Robin S.E. (1990) Evidence for less improvement in depression in patients taking benzodiazepines during unilateral E.C.TAm J Psychiatr147: 1029-1035
38.
Rasmussen J G C, Johnson A.M. (1991) 5th World Congress of Biological Psychiatry , Florence, 9-14 June, Racagni G, Brunello A, Fukuda T (eds). Excerpta Medica, New York
39.
Rich C.L., Black N.A. (1985) The efficacy of ECT: II. Correlation of specific treatment variables to response rate in unilateral ECT. Psychiatr Res16:107-154
40.
Rickels K., Schweizer E. (1990) Clinical overview of serotonin reuptake inhibitors . J Clin Psychiatr51 (Suppl. B): 9-12
41.
Roberts M.A., Attah J.R. (1988) Carbamazepine and ECT. Br J Psychiatr153: 418
42.
Robin A., De Tissera S. (1982) A double blind controlled comparison of the therapeutic effects of low and high energy electroconvulsive therapies. Br J Psychiatr141: 357-366
43.
Rosenstein D.L., Neslon J.C., Jacobs S.C. (1993) Seizures associated with antidepressants: a review . J Clin Psychiatr54: 289-299
44.
Royal College of Psychiatrists (1989) The practical administration of electroconvulsive therapy (ECT). ECT Sub-Committee of the Research Committee of the Royal College of Psychiatrists . Gaskell, London
45.
Rundfeldt C., Hoanck D., Loscher W. (1990) Phenytoin potentially increases the threshold for focal seizures in amygdala-kindled rats. Neuropharmacology29: 845-851
46.
Sackeim H.A., Decina P., Prohovnik I., Maltiz S., Resor S.R. (1983) Anticonvulsant and antidepressant properties of ECT: a proposed mechanism of action. Biol Psychiatr18: 1301-1309
47.
Sackeim H., Decina P., Prohovnik I., Malitz S. (1987) Seizure threshold in electroconvulsive therapy . Arch Gen Psychiatr44: 355-360
48.
Schmidt L.G., Grohmann R., Muler-Oerlinghausen B., Ochsenfahrt H., Schonhofer P.S. (1986) Adverse drug reactions to first and second generation antidepressants: a critical evaluation of drug surveillance data. Br J Psychiatr148: 38-43
49.
Scott A I F (1989) Biological predictors of recovery in ECT. Br J Psychiatr157: 10-17
50.
Simon R.P. (1988) Alcohol and seizures. New Engl J Med319: 715-716
51.
Standish-Barry H M A S, Deacon V., Snaith R.P. (1985) The relationship of concurrent benzodiazepine administration to seizure duration in ECT. Acta Psychiatr Scand71: 269-271
52.
Steppuhn K.G., Turski L. (1993) Modulation of the seizure threshold for excitatory amino acids in mice by anti epileptic drugs and chemoconvulsants. J Pharmacol Exp Therap265:1063-1070
53.
Stromgren L.S. (1973) Unilateral versus bilateral electroconvulsive therapy. Investigations into the therapeutic effect in endogenous depression. Acta Psychiatr Scand (Suppl.) 240, 8-65
54.
Stromgren L.S., Dahl J., Fjeldborg N., Thomsen A. (1980) Factors influencing seizure duration and number of seizures applied in unilateral electroconvulsive therapy. Acta Psychiatr Scand62: 158-165
