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Induction agents in electroconvulsive therapy: a comparison of methohexitone and propofol

Special Committee on ECT, The Royal College of Psychiatrists, Scottish Division, 9 Queen St, Edinburgh EH2 1JQ, UK

Harold Boddy, Senior House Officer in Psychiatry

Andrew Duncan Clinic, Royal Edinburgh Hospital, Morningside Terrace, Edinburgh EH10 5HF

Declaration of interest

None.

AIMS AND METHOD

To compare methohexitone and propofol in electroconvulsive therapy (ECT). A retrospective within-subject comparison was made of the use of these drugs in separate courses of bilateral ECT in one clinic over 10 years. Patients taking mood stabilising or anti-epileptic drugs were excluded. The initial seizure threshold and seizure duration were of particular interest.

RESULTS

The median initial seizure thresholds were identical (75 mC). The median initial seizure duration with threshold stimulation was 25% shorter with propofol (21 v. 28 s). The median total numbers of treatments in the courses were identical (eight treatments).

CLINICAL IMPLICATIONS

The shorter seizure duration observed with propofol was not associated with a commensurate rise in the initial seizure threshold. The shorter seizure duration may therefore have no effect on the therapeutic efficacy of treatment.