Recorded spontaneous seizure prior to electroconvulsive therapy after etomidate induction in a patient treated with bupropion: a case report.

IF 1.1 Q4 PSYCHIATRY

NEUROPSYCHIATRIE Pub Date : 2025-10-13 DOI:10.1007/s40211-025-00553-3

Evelyn Romina Pircher Nöckler, Laurin Mauracher, Lukas Gasteiger, Imrich Blasko

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Abstract

Background: Electroconvulsive therapy (ECT) is a widely used and effective treatment for refractory depression. Patients hospitalized for ECT regularly take antidepressants or adjuvant antipsychotics, both can influence the quality of seizures. Adaptation of the seizure threshold during an ECT series necessitates adjustments in treatment parameters to ensure adequate seizure quality.

Methods: We report the case of a 46-year-old man with treatment-resistant depression treated with bupropion and ECT, who developed a spontaneous seizure after first-time etomidate anesthesia induction, as previously induced seizures under thiopental were considered insufficient. Serendipitously, an electroencephalogram (EEG) of the seizure was recorded.

Results: The characteristics of the EEG captured after this spontaneous seizure were similar to those of regular ECT seizures under thiopental anesthesia in this patient. After returning to thiopental anesthesia, the remaining ECT course was unremarkable, and the patient's depressive symptoms improved partially.

Conclusion: Accordingly, the use of etomidate as an anesthesia induction agent for ECT in patients who are concomitantly using bupropion needs to be cautiously considered. The case of a documented etomidate-induced seizure could indicate the relatively benign course of such events.

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经安非他酮治疗的患者在依托咪酯诱导后电痉挛治疗前发生自发性癫痫：一例报告。

背景：电痉挛疗法（ECT）是一种广泛应用且有效的治疗顽固性抑郁症的方法。住院接受电痉挛治疗的患者定期服用抗抑郁药或辅助抗精神病药，两者都会影响癫痫发作的质量。在ECT系列中，癫痫发作阈值的调整需要调整治疗参数，以确保足够的癫痫发作质量。方法：我们报告了一例46岁的男性顽固性抑郁症患者，接受安非他酮和电痉挛治疗，他在首次使用依托咪酯麻醉诱导后发生自发性癫痫发作，因为先前使用硫喷妥诱导的癫痫发作被认为不足。偶然地，癫痫发作的脑电图（EEG）被记录下来。结果：自发性癫痫发作后的脑电图特征与硫喷妥钠麻醉下的常规电痉挛发作相似。在恢复硫喷妥钠麻醉后，余下的电痉挛疗程效果不显著，患者的抑郁症状得到部分改善。结论：因此，在同时使用安非他酮的患者中，使用依托咪酯作为电痉挛的麻醉诱导剂需要慎重考虑。有文献记载的依托咪酯诱发的癫痫发作可能表明此类事件的相对良性过程。

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来源期刊

NEUROPSYCHIATRIE PSYCHIATRY-

CiteScore

3.80

自引率

20.00%

发文量

期刊介绍： Die Zeitschrift ist das offizielle Organ der „Österreichischen Gesellschaft für Psychiatrie, Psychotherapie und Psychosomatik (ÖGPP)'', und wissenschaftliches Organ der Österreichischen Alzheimer Gesellschaft, der Österreichischen Gesellschaft für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, der Österreichischen Schizophreniegesellschaft, und der pro mente austria - Österreichischer Dachverband der Vereine und Gesellschaften für psychische und soziale Gesundheit.Sie veröffentlicht Übersichten zu relevanten Themen des Fachs, Originalarbeiten, Kasuistiken sowie Briefe an die Herausgeber. Zudem wird auch Buchbesprechungen sowie Neuigkeiten aus den Bereichen Personalia, Standes- und Berufspolitik sowie Kongressankündigungen Raum gewidmet.Thematisch ist das Fach Psychiatrie und die Methoden der Psychotherapie in allen ihren Facetten vertreten. Die Zeitschrift richtet sich somit an alle Berufsgruppen, die sich mit Ursachen, Erscheinungsformen und Behandlungsmöglichkeiten von psychischen Störungen beschäftigen. -----------------------------------------------------------------------------------------------------· The professional and educational journal of the Austrian Society of Psychiatry, Psychotherapy and Psychosomatics (Österreichische Gesellschaft für Psychiatrie, Psychotherapie und Psychosomatik; ÖGPP) and the Austrian Society of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (Österreichische Gesellschaft für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie; ÖGKJP)· Overviews of all relevant topics pertaining to the discipline· Intended for all occupational groups committed to the causes and manifestations of, as well as therapy options for psychic disorders· All manuscripts principally pass through a double-blind peer review process involving at least two independent expertsThe official journal of the Austrian Societies of Psychiatry, Psychotherapy and Psychosomatics (ÖGPP) and Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (ÖGKJP)The journal publishes overviews of relevant issues in the field, original work, case reports and letters to the editors. In addition, space is devoted to book reviews, news from the areas of personnel matters and professional policies, and conference announcements.Thematically, the discipline of psychiatry and the methods of psychotherapy are represented in all their facets. The journal is thus aimed at all professional groups committed to the causes and manifestations of, as well as therapy options for psychic disorders