PMID- 15791172
OWN - NLM
STAT- MEDLINE
DCOM- 20050708
LR  - 20191109
IS  - 1095-0680 (Print)
IS  - 1095-0680 (Linking)
VI  - 21
IP  - 1
DP  - 2005 Mar
TI  - Seizure length and clinical outcome in electroconvulsive therapy using 
      methohexital or thiopental.
PG  - 16-8
AB  - Seizure duration is an extensively studied and controversial indicator of 
      treatment quality in electroconvulsive therapy. Previous research comparing the 
      effect of the barbiturate anesthetics methohexital and thiopental on seizure 
      duration has yielded conflicting results. A recent period of unavailability of 
      methohexital in the United States allowed for retrospective comparison of seizure 
      length as well as clinical improvement in treatment using each agent. 
      Retrospective review was made of 837 treatments administered to 97 patients 
      between January 2, 2002, and May 31, 2003, examining anesthetic, seizure 
      duration, and Global Assessment of Functioning (GAF) scores of inpatients at 
      hospital admission and discharge. Analysis of variance of treatments 2-5 showed 
      no significant effect for anesthetic on seizure duration. Analysis on a 
      treatment-by-treatment basis revealed a marginally significant trend toward 
      shorter EEG seizures in the thiopental group at the second treatment (50.5 +/- 
      23.6 s vs. 61.1 +/- 27.9 s; P = 0.07) and fifth treatment (41.7 +/- 16.9 s vs. 
      51.8 +/- 24.0 s; P = 0.07). A difference approaching statistical significance 
      revealed shorter convulsion length in the thiopental group at treatment 5 (29.0 
      +/- 12.3 s vs. 34.8 +/- 12.3 s; P = 0.07). Comparison of GAF score improvement at 
      hospital discharge revealed no significant difference (GAF increase 26.4 +/- 9.4 
      for methohexital-treated patients vs. 24.8 +/- 12.0 for thiopental-treated 
      patients; t = 1.00, df = 82, P > 0.1). Trends approaching significance in 
      treatments 2 and 5 revealed shorter seizures in the thiopental group. However, 
      data on clinical recovery reveals no greater improvement in the methohexital 
      group. Thus, this study calls further into question the premise that choice of 
      barbiturate anesthetic may affect clinical efficacy.
FAU - Dew, Rachel E
AU  - Dew RE
AD  - Department of Psychiatry, Wake Forest University, Winston-Salem, NC, USA. 
      rdew@wfubmc.edu
FAU - Kimball, James N
AU  - Kimball JN
FAU - Rosenquist, Peter B
AU  - Rosenquist PB
FAU - McCall, W Vaughn
AU  - McCall WV
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - J ECT
JT  - The journal of ECT
JID - 9808943
RN  - 0 (Anesthetics, Intravenous)
RN  - E5B8ND5IPE (Methohexital)
RN  - JI8Z5M7NA3 (Thiopental)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Anesthesia
MH  - Anesthetics, Intravenous/*therapeutic use
MH  - Depressive Disorder/*therapy
MH  - *Electroconvulsive Therapy
MH  - Epilepsy
MH  - Female
MH  - Humans
MH  - Male
MH  - Methohexital/*therapeutic use
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Thiopental/*therapeutic use
MH  - Treatment Outcome
EDAT- 2005/03/26 09:00
MHDA- 2005/07/09 09:00
CRDT- 2005/03/26 09:00
PHST- 2005/03/26 09:00 [pubmed]
PHST- 2005/07/09 09:00 [medline]
PHST- 2005/03/26 09:00 [entrez]
AID - 00124509-200503000-00005 [pii]
AID - 10.1097/01.yct.0000154052.80893.f7 [doi]
PST - ppublish
SO  - J ECT. 2005 Mar;21(1):16-8. doi: 10.1097/01.yct.0000154052.80893.f7.