What is the role of beta blockade in electroconvulsive therapy (ECT)?

Updated: Sep 24, 2019
  • Author: Mehul V Mankad, MD; Chief Editor: Dennis M Popeo, MD  more...
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Answer

Answer

Due to tachycardia and associated rise in blood pressure (and presumably intracranial pressure) during ECT, clinicians may choose to proactively address the sympathetic nervous system response in patients prone to hypertension. Ideally, the patient's oral antihypertensive regimen would be optimized prior to their initiation of ECT. Once in the treatment room, clinicians can consider delivery of intravenous beta blockers prior to anesthesia induction. While esmolol is an effective intravenous beta blocker, it's anticonvulsant properties negatively impact seizure duration for the purposes of ECT. Other beta blockers, such as labetolol, are known to have less effect on seizure duration. [50]


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