The Effects of Etomidate on Seizure Duration and Electrical Stimulus Dose in Seizure-resistant Patients During Electroconvulsive Therapy

Abstract

Etomidate has a distinct advantage over thiopental in producing seizures of adequate duration during ECT and should be used as the first-line measure in augmenting seizures in patients who have very high seizure thresholds.

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

“…Etomidate is known to be helpful in cases where seizure induction is difficult or seizure duration is inadequate. 10 It may be that the use of etomidate was salient in this case.…”

“…9 Indeed, now, many centers use propofol or thiopental; however, these are thought to increase seizure threshold. 10 The practice of the ECT unit in question was to routinely use etomidate for induction of anesthesia. Etomidate is known to be helpful in cases where seizure induction is difficult or seizure duration is inadequate.…”

Exceptionally High Initial Seizure Threshold in a Catatonic Patient Treated With Electroconvulsive Therapy

“…18 Etomidate has been recommended as the first-line anesthetic for patients with very high seizure thresholds. 15 Because we routinely administer etomidate, lowering the seizure threshold by switching to another anesthetic was not an option with our patient. The cardiovascular condition of our patient was severely compromised as shown by the transient ischemic attack during the treatment period.…”

Exceptionally High Initial Seizure Threshold in a Patient Treated With Electroconvulsive Therapy

“…The use of etomidate in preference to other anesthetic agents has been shown to allow seizure activity at lower doses of ECT. 16 Factors that would increase the seizure threshold in this case were bilateral electrode placement, 8,9 the use of propofol in sessions 1 and 3, 15 and prescribed antiepileptic medication used for mood stabilization.…”