Investigating Anxiety’s Impact on Seizure Quality in Electroconvulsive Therapy: A Prospective Observational Study

J ECT. 2024 Dec 17. doi: 10.1097/YCT.0000000000001097. Online ahead of print.

ABSTRACT

BACKGROUND: Electroconvulsive therapy (ECT) is a medical procedure for treating severe depression and other mental health disorders, with anesthesia management being crucial for patient safety. Despite extensive research on factors influencing seizure quality during ECT, the impact of pre-ECT anxiety remains insufficiently explored.

METHODS: This prospective observational study aimed to investigate the influence of pre-ECT anxiety, as measured by the Amsterdam Preoperative Anxiety and Information Scale, on electroencephalogram ictal characteristics during ECT and to explore anesthesia-related factors that may enhance seizure quality.

RESULTS: A total of 38 patients participated in 168 documented ECT sessions over a 2-month period. Data analysis revealed a significant association between higher levels of pre-ECT anxiety, lidocaine doses exceeding 0.36 mg/kg, and decreased seizure quality during ECT sessions.

CONCLUSION: These findings suggest an association between pre-ECT anxiety, lidocaine dosage, and decreased seizure quality during ECT. Further research, including interventional studies, is required to better understand the causal factors.

PMID:39715276 | DOI:10.1097/YCT.0000000000001097