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Electro convulsive therapy: Modification of its effect on the autonomic nervous system using anti-cholinergic drugs

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@article{3ebdfb47e5ff4d55b5d9d3f44c1eb8a0,
title = "Electro convulsive therapy: Modification of its effect on the autonomic nervous system using anti-cholinergic drugs",
abstract = "The antidepressant efficacy of electroconvulsive therapy (ECT) is correlated to the quality of the seizure as measured by EEG but has also been linked to the magnitude of changes in hemodynamic variables. Muscarinic receptor antagonists are frequently used in the treatment, and are known to affect the hemodynamic response. We hypothesized that atropine and glycopyrrolate alter the hemodynamic and autonomic hormonal response to ECT. In a randomized, cross-over study design 23 patients received either atropine, glycopyrrolate or placebo before ECT. Hemodynamic variable, EEG and EMG, and blood adrenaline, noradrenaline and pancreatic polypeptide was determined. No geriatric patients were included. Hemodynamic changes with ECT can be divided into three phases: Drop in blood pressure and pulse rate in 1st post-stimulus phase was less when using 1 mg atropine. In 2nd post-stimulus phase atropine gave a higher systolic blood pressure. No differences were seen in hormone levels after ECT in the three interventions. A significant longer tonic clonic seizure was seen in the glycopyrrolate group and a tendency of the same was seen with atropine. The study found that the changes in hemodynamic variables induced by ECT can be altered by concomitant administration of muscarinic receptor antagonist.",
author = "Christensen, {S{\o}ren T Just} and Staals{\o}, {Jonathan Myrup} and Anders J{\o}rgensen and Pia Weikop and Olsen, {Niels Vidiendal} and J{\o}rgensen, {Martin Balslev}",
note = "Copyright {\circledC} 2018 Elsevier B.V. All rights reserved.",
year = "2019",
doi = "10.1016/j.psychres.2018.11.035",
language = "English",
volume = "271",
pages = "239--246",
journal = "Psychiatry Research",
issn = "0165-1781",
publisher = "Elsevier Ireland Ltd",

}

RIS

TY - JOUR

T1 - Electro convulsive therapy

T2 - Modification of its effect on the autonomic nervous system using anti-cholinergic drugs

AU - Christensen, Søren T Just

AU - Staalsø, Jonathan Myrup

AU - Jørgensen, Anders

AU - Weikop, Pia

AU - Olsen, Niels Vidiendal

AU - Jørgensen, Martin Balslev

N1 - Copyright © 2018 Elsevier B.V. All rights reserved.

PY - 2019

Y1 - 2019

N2 - The antidepressant efficacy of electroconvulsive therapy (ECT) is correlated to the quality of the seizure as measured by EEG but has also been linked to the magnitude of changes in hemodynamic variables. Muscarinic receptor antagonists are frequently used in the treatment, and are known to affect the hemodynamic response. We hypothesized that atropine and glycopyrrolate alter the hemodynamic and autonomic hormonal response to ECT. In a randomized, cross-over study design 23 patients received either atropine, glycopyrrolate or placebo before ECT. Hemodynamic variable, EEG and EMG, and blood adrenaline, noradrenaline and pancreatic polypeptide was determined. No geriatric patients were included. Hemodynamic changes with ECT can be divided into three phases: Drop in blood pressure and pulse rate in 1st post-stimulus phase was less when using 1 mg atropine. In 2nd post-stimulus phase atropine gave a higher systolic blood pressure. No differences were seen in hormone levels after ECT in the three interventions. A significant longer tonic clonic seizure was seen in the glycopyrrolate group and a tendency of the same was seen with atropine. The study found that the changes in hemodynamic variables induced by ECT can be altered by concomitant administration of muscarinic receptor antagonist.

AB - The antidepressant efficacy of electroconvulsive therapy (ECT) is correlated to the quality of the seizure as measured by EEG but has also been linked to the magnitude of changes in hemodynamic variables. Muscarinic receptor antagonists are frequently used in the treatment, and are known to affect the hemodynamic response. We hypothesized that atropine and glycopyrrolate alter the hemodynamic and autonomic hormonal response to ECT. In a randomized, cross-over study design 23 patients received either atropine, glycopyrrolate or placebo before ECT. Hemodynamic variable, EEG and EMG, and blood adrenaline, noradrenaline and pancreatic polypeptide was determined. No geriatric patients were included. Hemodynamic changes with ECT can be divided into three phases: Drop in blood pressure and pulse rate in 1st post-stimulus phase was less when using 1 mg atropine. In 2nd post-stimulus phase atropine gave a higher systolic blood pressure. No differences were seen in hormone levels after ECT in the three interventions. A significant longer tonic clonic seizure was seen in the glycopyrrolate group and a tendency of the same was seen with atropine. The study found that the changes in hemodynamic variables induced by ECT can be altered by concomitant administration of muscarinic receptor antagonist.

U2 - 10.1016/j.psychres.2018.11.035

DO - 10.1016/j.psychres.2018.11.035

M3 - Journal article

VL - 271

SP - 239

EP - 246

JO - Psychiatry Research

JF - Psychiatry Research

SN - 0165-1781

ER -

ID: 55757445