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Change in barbiturate anaesthesic sensitivity as a prognostic indicator of electroconvulsive therapy outcome
Author(s) -
Barry S.,
Rowan M. J.,
Mulhall J.,
Webb M. G. T.
Publication year - 1991
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/j.1600-0447.1991.tb05535.x
Subject(s) - electroconvulsive therapy , barbiturate , anesthesia , depression (economics) , psychology , medicine , electroconvulsive shock , economics , macroeconomics
Barbiturate anaesthesia is modulated by brain noradrenergic (NA) function. As derangement of NA pathways is postulated to occur in depression, changes in anaesthetic sensitivity measured as producing loss of eyelash reflex were monitored in 29 depressed patients throughout a course of electroconvulsive therapy (ECT). Patients thus monitored were followed for 12 months after completing treatment. An increase in barbiturate induction dose over a course of ECT, indicating a decrease in anaesthetic sensitivity, was a powerful predictor of maintained wellbeing. All patients who increased their sensitivity to the anaesthetic either failed to respond to the course of ECT or relapsed within 12 months. The possible mechanism for this is discussed.