Pharmacopsychiatry 2005; 38 - A174
DOI: 10.1055/s-2005-918796

The influence of concomitant neuroleptic medication on safety, tolerability and clinical effectiveness of electroconvulsive therapy

C Nothdurfter 1, D Eser 1, C Schüle 1, PM Zwanzger 1, A Marcuse 1, I Noack 1, HJ Möller 1, R Rupprecht 1, TC Baghai 1
  • 1Ludwig-Maximilians-Universität LMU München, Klinik und Poliklinik für Psychiatrie und Psychotherapie, München

Electroconvulsive therapy (ECT) is considered to be the most efficacious treatment option in major depressive disorder and treatment resistant schizophrenia. Unfortunately, in some cases patients do not respond sufficiently to conventional ECT. In these cases concomitant pharmacotherapy can be useful to improve clinical effectiveness.

We evaluated 5482 treatments in 455 patients in our retrospective study to see whether there might be differences between ECT and concomitant neuroleptic medication and ECT monotherapy. We focused on clinical effectiveness and tolerability, treatment modalities and ictal neurophysiological parameters that might be influenced.

Seizure duration according EEG-derivations turned out to be significantly longer in patients treated with low potency neuroleptics, seizure-duration in EMG was shorter in treatments done with atypical substances. Postictal suppression was highest in treatments done with atypical neuroleptics, whereas the same group was lowest regarding convulsion energy- and convulsion concordance-indices. The best clinical effectiveness was seen in treatments done with atypical substances. Adverse effects were not influenced significantly by concomitant neuroleptic medication.

Our study suggests that combining ECT treatment with neuroleptic medication might be of clinical benefit; especially atypical substances seem to enhance improvement. The tolerability of ECT treatment was not influenced by concomitant neuroleptic medication.