thiopental and Mood-Disorders

Preliminary evidence suggests that the use of ketamine during electroconvulsive therapy (ECT) may be neuroprotective against cognitive impairment and have synergistic antidepressant effects. This study tested whether the addition of ketamine reduced cognitive impairment and enhanced efficacy over a course of ECT, in a randomised, placebo-controlled, double-blind study.. Fifty-one depressed patients treated with ultrabrief pulse-width right unilateral ECT were randomised to receive either ketamine (0.5mg/kg) or placebo (saline) in addition to thiopentone during anaesthesia for ECT. Neuropsychological outcomes (measured before ECT, after six treatments, and after the final ECT treatment) and mood outcomes (measured before ECT, and weekly after every three ECT treatments) were measured by a rater blinded to treatment condition.. Neuropsychological outcomes did not differ between groups. The ECT-ketamine group had a slightly greater improvement in depressive symptoms over the first week of treatment and at one-week follow up, though there was no overall difference in efficacy at the end of the ECT course. No psychomimetic effects were detected.. The study was conducted in a clinical setting, so not all aspects of ECT treatment were fully controlled. Thiopentone doses differed slightly between groups, in order to accommodate the addition of ketamine to the anaesthetic.. The addition of ketamine did not decrease cognitive impairment in patients having ultrabrief pulse-width right unilateral ECT, but was safe and slightly improved efficacy in the first week of treatment and at one-week follow up.. Clinicaltrials.gov ID: NCT00680433. Ketamine as an anaesthetic agent in electroconvulsive therapy (ECT). www.clinicaltrials.gov.

Topics: Adult; Affect; Bipolar Disorder; Cognition; Cognition Disorders; Depressive Disorder, Major; Double-Blind Method; Electroconvulsive Therapy; Electroencephalography; Female; Follow-Up Studies; Humans; Ketamine; Male; Middle Aged; Mood Disorders; Neuroprotective Agents; Neuropsychological Tests; Thiopental; Treatment Outcome

For safe conduct of electro convulsive therapy (ECT), general anaesthesia is administered to the patients. In this study we compared thiopentone sodium and propofol as induction agents for ECT.. Twenty five patients each undergoing at least 2 sessions of ECT at the psychiatry department were included in the study. Each patient either received thiopentone or propofol for induction of sleep in a randomized manner. Drugs were evaluated regarding their effects on ECT induced haemodynamic changes (Blood pressure, Heart rate), seizure duration related to the procedure and recovery from sleep. Any side effects during the procedure and recovery were also noted.. Propofol offered a superior haemodynamic stability during the procedure and a quick recovery from sleep.. Propofol was found to be a better induction agent for ECT compared to thiopentone sodium.

Topics: Adult; Anesthesia, Intravenous; Anesthetics, Intravenous; Electrocardiography; Electroconvulsive Therapy; Female; Humans; Male; Mood Disorders; Propofol; Thiopental

In a double-blind study, 57 patients were anaesthetized with either Althesin, thiopentone, or fentanyl combined with diazepam for cystoscopies. One and a half and four hours after the administration of anaesthesia, the patients were investigated with an objective neuropsychological method, continuous Reaction Time, and with a subjective rating scale. Beecher's Mood Scale. One week later the patients answered a questionnaire about side-effects experienced during the days following anaesthesia. At the 1 1/2 h investigation, the patients were cerebrally affected, both subjectively and objectively. The CNS-dysfunction was different for the three anaesthetics. After administration of thiopentone, the patients experienced the highest degree of subjective effects but had the smallest reaction time prolongation. Fentanyl-diazepam gave the least subjective effects, but the highest degree of cerebral affection in the reaction time measurements. The effects of Althesin were intermediate. Four hours after anaesthesia, the reaction time prolongations had disappeared, except for Althesin, and only patients who had thiopentone registered subjective effects. The number of side-effects was greatest and most prolonged following thiopentone. About 25% of the patients reported that side-effects had persisted more than 1 day after anaesthesia.

Topics: Adult; Aged; Alfaxalone Alfadolone Mixture; Anesthetics; Clinical Trials as Topic; Cognition Disorders; Diazepam; Double-Blind Method; Female; Fentanyl; Humans; Male; Middle Aged; Mood Disorders; Postoperative Period; Pregnanediones; Thiopental

Reports of delayed recovery from anesthesia by patients concurrently receiving lithium carbonate and a neuromuscular blocker have been followed by a recommendation to avoid such a combination and, hence, concurrent treatment with lithium and electroconvulsive therapy (ECT). The authors review the literature and their clinical experience with such a drug combination at one psychiatric hospital. They conclude that the clinical and experimental findings to date are insufficient to warrant proscribing the combination of lithium and ECT on the basis of possible potentiation of neuromuscular blockade by lithium.

Topics: Adult; Aged; Drug Synergism; Electroconvulsive Therapy; Female; Humans; Lithium; Lithium Carbonate; Male; Middle Aged; Mood Disorders; Succinylcholine; Thiopental

Topics: Adult; Aged; Anesthesia; Anesthetics, Intravenous; Arrhythmias, Cardiac; Electrocardiography; Electroconvulsive Therapy; Female; Humans; Male; Methohexital; Middle Aged; Mood Disorders; Schizophrenia; Thiopental