What is the role of medications in electroconvulsive therapy (ECT)?
Patients who are recommended for ECT may be on treatment for other diseases, thus it is appropriate for them to be assessed by their doctor so their medicines could be altered. Some drugs are increased while others decreased or withdrawn. Before the treatment, medicines that decrease acute risks from anaesthesia or ECT can be given. These include; corticosteroids, antihypertensive, anti arrhythmatics, bronchodilators, and glaucoma medications. However, diuretics and hypoglycemics should be stopped and resumed after the treatment. Antacid medications and proton pump inhibitors may be safely used. Studies show that caffeine in the form of caffeine sodium benzoate intravenous injection 250–1,000 mg, along with other methylxanthines have also been administered to increase the duration of seizure however, it doesn’t reduce the seizure threshold. This is not preferred as caffeine cause cardiac complications. Anticonvulsants or antiseizure drugs and tranquilizers such as benzodiazepines should be reduced as they will hinder the response of ECT. Beta-blockers are drugs that reduce the sympathetic response of the body by blocking the effect of adrenaline. They are administered before starting electroconvulsive therapy to control tachycardia and rise in blood pressure which might be induced after the treatment. Patients with hypertension are more prone to tachycardia, thus beta-blockers must be administered to them at all costs. Esmolol is the preferred drug, however, Labetalol can be used as an alternative. Anticholinergics are used before surgeries and treatments like electroconvulsive therapy to maintain body functions while the person is under the effect of anesthesia. They reduce the cardiovascular response to vagal stimulation resulting in tachycardia and reduce the secretions of the respiratory system ECT is more effective when used in combination with antipsychotic drugs in schizophrenia.