Abstract
Introduction: The short-acting narcotic propofol is used for sedation during electroconvulsive
therapy (ECT). It remains unclear whether patients develop tolerance to propofol after
repeated administration. Therefore, we studied whether propofol dosage had to be increased
during a course of ECT.
Methods: This retrospective study evaluated records of 39 in- and outpatients at a Swiss psychiatric
hospital who underwent 10–21 ECT sessions for affective disorder over 4–28 weeks in
2011–2013. We examined the dose of propofol required to achieve deep sedation at the
first and last ECT sessions.
Results: 13/39 patients (33.3%) needed a slightly higher propofol dose at the last ECT session
than at the first (Group 1), 12 patients (30.8%) needed the same dose at the first
and last sessions (Group 2) and 14 patients (35.9%) needed a lower final dose (Group
3).
Conclusions: In our study patients did not appear to develop tolerance to propofol after repeated
administration. Although the lack of a systematic dosing scheme in our study limits
the conclusions that can be drawn, recent studies in animal models indicate that tolerance
development is rather unlikely with propofol. Further studies are required to clarify
the question of whether repeated use of propofol leads to tolerance.
Key words
propofol - misuse - dependence - addiction - toxicity
