Should Psychotropic Medications Be Discontinued Before ECT?

Because of concerns that psychotropic medications, such as benzodiazepines and anticonvulsants, could adversely affect seizure threshold, seizure duration, and tolerability, clinicians question whether patients should discontinue these medications prior to electroconvulsive therapy (ECT). To address the question, investigators retrospectively reviewed charts of 550 patients with various disorders (mean age, 54) beginning ECT treatment (mostly unilateral) by the same four psychiatrists at a single institution over a 27-month period in the mid-1990s.

During the 2 days preceding ECT, 85% of patients were taking any of these psychotropic medication classes or medicines:

• Benzodiazepines, 63%

• Other sedative-hypnotics, such as barbiturates, 17%

• Antips…