Predictors of Postictal Delirium Following Electroconvulsive Therapy in a Sample of Patients With Schizophrenia: An Egyptian Experience.

Abstract

Purpose: Electroconvulsive therapy (ECT) is recognized as an effective treatment for patients with schizophrenia. However, it is sometimes followed by adverse effects that are usually self-limiting. Postictal delirium (PID) is an adverse effect that is difficult to predict and requires further study.

Patients and methods: An observational cross-sectional study was conducted on patients with schizophrenia receiving ECT. The selected patients underwent the Delirium Observation Scale and Mini-Mental State Examination. Also, clinical characteristics and ECT-related variables were included in the study.

Results: A total of N=69 patients were included in the study. The ages ranged from 18 to 55 years, with a mean age of 34.5 years; 60.8% (N=42) were males. Among males, just over half (54.7%) smoked tobacco. BMI indicated that most participants fell within the normal to overweight range. There were no significant differences between patients with and without PID in terms of age, BMI, medical comorbidity, either first-generation or second-generation antipsychotics, and ECT stimulus dose. However, use of clozapine, anticholinergic medications, a combination of first-generation and second-generation antipsychotics, presence of catatonia, smoking, longer seizure duration, and a 1-day gap between sessions were associated with PID.

Conclusion: Regression analysis identified several clinical and treatment features associated with PID development. Prevention strategies may be targeted to these factors.