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Concurrent Electroconvulsive Therapy and Bupropion Treatment
- Source :
- The Journal of ECT. 33:185-189
- Publication Year :
- 2017
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2017.
-
Abstract
- Background Bupropion is associated with a dose-dependent increased risk of seizures. Use of concomitant bupropion and electroconvulsive therapy (ECT) remains controversial because of an increased risk of prolonged seizures. This is the first systematic evaluation of the effect of bupropion on ECT. Methods A case group (n = 119), patients treated with concomitant ECT and bupropion, was compared with an age and gender frequency-matched control group (n = 261), treated with only ECT. Electroconvulsive therapy treatment data including seizure length, number of treatments, and concurrent medications were extracted. Longitudinal mixed models examined ECT versus ECT + bupropion group differences over the course of treatments measured by seizure duration (electroencephalogram [EEG] and motor). Multivariable models examined the total number of treatments and first and last seizure duration. All models considered group differences with ECT treatment measures adjusted for age, gender, benzodiazepine treatment, lead placement, and setting. Results Electroconvulsive therapy treatment with bupropion led to shorter motor seizure duration (0.047) and EEG seizure duration (P = 0.001). The number of ECT treatments (7.3 vs 7.0 treatments; P = 0.23), respectively, or the probability of a prolonged seizure (P = 0.15) was not significantly different. Benzodiazepine use was significantly more common in control subjects (P = 0.01). Limitations This is a retrospective analysis limited in part by unavailable variables (seizure threshold, nature of EEG and motor seizure monitoring, type of ECT device, dosing and formulation of bupropion, and duration of the current depressive illness). Conclusions This study revealed a significantly shorter duration in seizure length with ECT + concomitant bupropion, but not in the number of required treatments in those treated compared with ECT without bupropion. There remains a critical need to reevaluate the efficacy of concomitant use of psychotropic medications + ECT.
- Subjects :
- Adult
Male
medicine.drug_class
medicine.medical_treatment
Neuroscience (miscellaneous)
Electroencephalography
behavioral disciplines and activities
03 medical and health sciences
0302 clinical medicine
Electroconvulsive therapy
Seizures
mental disorders
Humans
Medicine
Dosing
Electroconvulsive Therapy
Bupropion
Aged
Retrospective Studies
Depressive Disorder, Major
Benzodiazepine
Seizure threshold
medicine.diagnostic_test
business.industry
Mental Disorders
Retrospective cohort study
Middle Aged
Combined Modality Therapy
030227 psychiatry
Psychiatry and Mental health
Case-Control Studies
Concomitant
Anesthesia
Antidepressive Agents, Second-Generation
Female
business
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- ISSN :
- 15334112 and 10950680
- Volume :
- 33
- Database :
- OpenAIRE
- Journal :
- The Journal of ECT
- Accession number :
- edsair.doi.dedup.....7159158fc1ea93dd0b4e6d6c8384ff66