A Case of Prolonged Seizure After ECT in a Patient Treated With Clomipramine, Lithium, L-Tryptophan, Quetiapine, and Thyroxine for Major Depression

Rucker, James; Cook, Marilyn

doi:10.1097/yct.0b013e31815bd768

Cited by 12 publications

(14 citation statements)

References 9 publications

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“…In clinical practice, suddenly occurring prolonged seizures can never be ruled out particularly in treatment-resistant patients with combinations of psychotropic drugs ( Rucker and Cook, 2008 ). This, however, could be ruled out widely for our patients who received moderate doses of mirtazapine and duloxetine only.…”

Section: Discussionmentioning

confidence: 99%

Risk Assessment of Electroconvulsive Therapy in Clinical Routine: A 3-Year Analysis of Life-Threatening Events in More Than 3,000 Treatment Sessions

Hajak

Hajak²,

Ziegelmayer³

et al. 2021

Front. Psychol.

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Background: Extensive research has reported that electroconvulsive therapy (ECT) can be highly effective in approximately 80% of patients suffering from depression. Its clinical use is mainly limited by historical objections and the concern about unwanted adverse effects (AEs), including serious and potentially life-threatening adverse events (pLTAEs), induced either by ECT or by anesthesia. Objective risk estimation is, therefore, a decisive factor in determining an indication for ECT.Methods: This paper presents a retrospective analysis of 3-year safety protocols and patient files of 157 patients who received a total of 3,106 ECT applications in a psychiatric inpatient setting at a psychiatric community hospital. This patient group comprises 5.3% of inpatients admitted with comparable diagnoses. Adverse events were analyzed from standardized safety protocols and patient files with a focus on pLTAEs.Results: Adverse events were reported for 30 (19.1%) of the 157 participants during 39 (6.1%) of 641 hospital stays. Serious pLTAEs occurred during three electroconvulsive stimulations in three patients, who needed action through the administration of medication or mechanical respiration. No patient suffered permanent damage to health, and no patient died. The incidence of these and other AEs was independent of sex, age, and diagnosis of patients, and anesthesia medication. Minor AEs occurred more often with higher stimulus doses and an increasing number of treatments.Conclusion: The low incidence rate of 0.097% of serious pLTAEs that require medical action may allow the conclusion that ECT is a rather safe treatment when performed in a controlled setting. The beneficial risk profile of ECT performed in the standard care of psychiatric hospitals suggests a more generous indication of this treatment method. We recommend that ECT facilities collect individual safety data to allow a reliable judgment of their institutional ECT risk profile.

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Section: Discussionmentioning

confidence: 99%

Risk Assessment of Electroconvulsive Therapy in Clinical Routine: A 3-Year Analysis of Life-Threatening Events in More Than 3,000 Treatment Sessions

Hajak

Hajak²,

Ziegelmayer³

et al. 2021

Front. Psychol.

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“…This patient may have experienced a mild prolonged seizure, given the improvement with the anti-seizure medication lorazepam, as well as previously documented prolonged seizure side effects from combining lithium with ECT treatment [3,[6][7][8]11]. Also, this patient had been receiving polypharmacy medication, including trazadone, duloxetine, buproprion, and lithium prior to ECT treatment.…”

Section: Discussionmentioning

confidence: 99%

“…In the case report by Conway and Nelson [7] describing prolonged seizures during ECT, the patient was being treated with buproprion, venlafaxine, and lithium. A similar article by Rucker and Cook [11] recorded polypharmacy treatment of clomipramine, lithium, 1-tryptophan, quetiapine, and thyroxine leading to prolonged seizures with ECT.…”

Section: Introductionmentioning

confidence: 99%

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A Case Report of ECT and Muscle Spasms

Turner¹,

Gunther²,

Husain³

et al. 2017

J Pharmacovigilance

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“…SE is defined as sustained or repeated epileptic seizure that lasts for more than 30 minutes and can be divided into status epilepticus with and without convulsions. Over the last couple of decades, only 13 cases of generalized nonconvulsive SE [5] and three cases of generalized convulsive SE provoked by ECT [6][7][8] have been identified in the literature. SE is associated with more than 20% mortality among adults [1,9].…”

Section: Introductionmentioning

confidence: 99%

Convulsive Status Epilepticus Induced by Electroconvulsive Therapy in a Patient with Major Depression

Wieben

Kjeldsen

Sørensen

2022

Case Reports in Psychiatry

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Electroconvulsive therapy (ECT) is a well-known, safe, and efficient treatment for a variety of psychiatric diseases. We present here an unusual case of a 34-year-old patient with major depression, who developed convulsive status epilepticus persistent for eight days in connection to her first ECT—a very uncommon but serious complication. The patient was, prior to ECT treatment, treated with lithium carbonate and clomipramine for her depression. Six years prior to the ECT, the patient had experienced a convulsive syncope resulting in traumatic subarachnoid haemorrhage. This case emphasizes the importance of medical recording to detect possible risk factors when considering ECT treatment.

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A Case of Prolonged Seizure After ECT in a Patient Treated With Clomipramine, Lithium, L-Tryptophan, Quetiapine, and Thyroxine for Major Depression

Cited by 12 publications

References 9 publications

Risk Assessment of Electroconvulsive Therapy in Clinical Routine: A 3-Year Analysis of Life-Threatening Events in More Than 3,000 Treatment Sessions

Risk Assessment of Electroconvulsive Therapy in Clinical Routine: A 3-Year Analysis of Life-Threatening Events in More Than 3,000 Treatment Sessions

A Case Report of ECT and Muscle Spasms

Convulsive Status Epilepticus Induced by Electroconvulsive Therapy in a Patient with Major Depression

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