The effects of diltiazem on hemodynamics and seizure duration during electroconvulsive therapy

Anesthesia and Analgesia
Zen'ichiro WajimaR Ogawa

Abstract

Electroconvulsive therapy (ECT) is often associated with acute hyperdynamic responses, and we hypothesize that diltiazem can blunt this response. We measured the effect of a 10-mg dose of diltiazem on heart rate and mean arterial pressure during ECT. Furthermore, we assessed seizure duration by using both the cuff method and two-lead electroencephalogram. We studied 18 patients with a randomized, double-blinded, placebo-controlled cross-over study design. Diltiazem significantly reduced heart rate and mean arterial pressure just after medication, and it also significantly reduced the increases in these variables after ECT, as compared with the placebo. The use of diltiazem was, however, associated with a shortened seizure duration, possibly making ECT less effective. Because of the reduction in seizure duration, the routine administration of diltiazem may not be advisable because it can possibly interfere with the psychotherapeutic efficacy of ECT. However, diltiazem medication for ECT is potentially useful for reducing tachycardia and hypertension in high-risk patients. Diltiazem can blunt acute hyperdynamic responses after electroconvulsive therapy, but seizure duration is also significantly reduced, possibly making this ther...Continue Reading

References

Jul 1, 1991·Anesthesia and Analgesia·O KemmotsuJ S Eckerle
Feb 1, 1989·Anaesthesia and Intensive Care·D G WellsF Rosewarne
Jun 1, 1988·The Journal of Nervous and Mental Disease·S Foster, R Ries
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Citations

Apr 8, 2020·Acta Neurologica Scandinavica·Gaetano ZaccaraEmilio Russo
Apr 7, 2012·International Anesthesiology Clinics·Viji Kurup, Robert Ostroff
Apr 26, 2002·Anesthesia and Analgesia·Zhengnian Ding, Paul F White
Dec 24, 2016·The Journal of ECT·Taylor MorrisetteP Brittany Vickery
Nov 10, 2018·Neuropsychopharmacology Reports·Yoko SuzukiEisuke Matsushima
Aug 18, 2021·Journal of Geriatric Psychiatry and Neurology·Syed Muhammad Ahsan Mehdi, D P Devanand

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