{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T18:53:53Z","timestamp":1789844033232,"version":"4.0.1"},"reference-count":91,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2017,5,2]],"date-time":"2017-05-02T00:00:00Z","timestamp":1493683200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["www.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Acta Neuropsychiatr."],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec id=\"S0924270817000126_abs1\" sec-type=\"general\"><jats:title>Objective<\/jats:title><jats:p>The objective of this review is to investigate existing literature in order to delineate whether the use of anaesthesia and timing of seizure induction in a new and optimised way may improve the efficacy of electroconvulsive therapy (ECT).<\/jats:p><\/jats:sec><jats:sec id=\"S0924270817000126_abs2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>PubMed\/MEDLINE was searched for existing literature, last search on 24 June 2015. Relevant clinical studies on human subjects involving choice of anaesthetic, ventilation and bispectral index (BIS) monitoring in the ECT setting were considered. The references of relevant studies were likewise considered.<\/jats:p><\/jats:sec><jats:sec id=\"S0924270817000126_abs3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Propofol yields the shortest seizures, etomidate and ketamine the longest. Etomidate and ketamine+propofol 1 : 1 seems to yield the seizures with best quality. Seizure quality is improved when induction of ECT is delayed until the effect of the anaesthetic has waned \u2013 possibly monitored with BIS values. Manual hyperventilation with 100% O<jats:sub>2<\/jats:sub>may increase the pO<jats:sub>2<\/jats:sub>\/pCO<jats:sub>2<\/jats:sub>-ratio, which may be correlated with better seizure quality.<\/jats:p><\/jats:sec><jats:sec id=\"S0924270817000126_abs4\" sec-type=\"conclusion\"><jats:title>Conclusion<\/jats:title><jats:p>Etomidate or a 1 : 1 ketamine and propofol combination may be the best method to achieve general anaesthesia in the ECT setting. There is a need for large randomised prospective studies comparing the effect of methohexital, thiopental, propofol, ketamine, propofol+ketamine 1 : 1 and etomidate in the ECT treatment of major depressed patients. These studies should investigate safety and side effects, and most importantly have antidepressant efficacy and cognitive side effects as outcome measures instead of seizure quality.<\/jats:p><\/jats:sec>","DOI":"10.1017\/neu.2017.12","type":"journal-article","created":{"date-parts":[[2017,5,2]],"date-time":"2017-05-02T12:10:16Z","timestamp":1493727016000},"page":"61-69","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":39,"title":["Anaesthesia for electroconvulsive therapy \u2013 new tricks for old drugs: a systematic review"],"prefix":"10.1017","volume":"30","author":[{"given":"Tobias Kvist","family":"Stripp","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin Balslev","family":"Jorgensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels Vidiendal","family":"Olsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2017,5,2]]},"reference":[{"key":"S0924270817000126_ref65","doi-asserted-by":"publisher","DOI":"10.2174\/1570159X113119990043"},{"key":"S0924270817000126_ref32","doi-asserted-by":"publisher","DOI":"10.1097\/0b013e31814da971"},{"key":"S0924270817000126_ref91","doi-asserted-by":"publisher","DOI":"10.3109\/08039488.2014.1003403"},{"key":"S0924270817000126_ref55","doi-asserted-by":"publisher","DOI":"10.1016\/j.lfs.2014.02.014"},{"key":"S0924270817000126_ref54","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2011.03.019"},{"key":"S0924270817000126_ref38","first-page":"217","article-title":"Ketamine anesthesia in electroconvulsive therapy","volume":"12","author":"Rasmussen","year":"1996","journal-title":"Convuls Ther"},{"key":"S0924270817000126_ref13","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1176\/jnp.7.3.295","article-title":"The ictal EEG as a marker of adequate stimulus intensity with unilateral ECT","volume":"7","author":"Krystal","year":"1995","journal-title":"J Neuropsychiatry Clin Neurosci"},{"key":"S0924270817000126_ref59","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2012.12040531"},{"key":"S0924270817000126_ref37","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-198206000-00012"},{"key":"S0924270817000126_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2012.12.019"},{"key":"S0924270817000126_ref68","doi-asserted-by":"publisher","DOI":"10.1016\/S0736-4679(96)00350-2"},{"key":"S0924270817000126_ref36","doi-asserted-by":"publisher","DOI":"10.1016\/S0306-4522(02)00652-8"},{"key":"S0924270817000126_ref33","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1097\/YCT.0b013e318271200b","article-title":"Effect of propofol versus sodium thiopental on electroconvulsive therapy in major depressive disorder: a randomized double-blind controlled clinical trial","volume":"29","author":"Purtuloglu","year":"2013","journal-title":"J ECT"},{"key":"S0924270817000126_ref31","doi-asserted-by":"publisher","DOI":"10.1177\/0300060513509036"},{"key":"S0924270817000126_ref35","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2013.06.003"},{"key":"S0924270817000126_ref57","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2013.128"},{"key":"S0924270817000126_ref29","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0b013e31823a4220"},{"key":"S0924270817000126_ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2008.03.004"},{"key":"S0924270817000126_ref34","doi-asserted-by":"publisher","DOI":"10.1097\/01.yct.0000230362.96615.d9"},{"key":"S0924270817000126_ref27","doi-asserted-by":"publisher","DOI":"10.1097\/01.yct.0000244238.17791.a4"},{"key":"S0924270817000126_ref25","doi-asserted-by":"publisher","DOI":"10.2174\/0929867003375335"},{"key":"S0924270817000126_ref12","doi-asserted-by":"publisher","DOI":"10.1038\/sj.npp.1300377"},{"key":"S0924270817000126_ref44","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2010.90"},{"key":"S0924270817000126_ref21","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199407000-00014"},{"key":"S0924270817000126_ref20","first-page":"433","article-title":"Pro- and anticonvulsant effects of anesthetics (part II)","volume":"70","author":"Modica","year":"1990","journal-title":"Anesth Analg"},{"key":"S0924270817000126_ref18","doi-asserted-by":"publisher","DOI":"10.2165\/00023210-200519090-00002"},{"key":"S0924270817000126_ref19","unstructured":"Katzung BG . Basic and clinical pharmacology, 10th edn. The McGraw-Hill Companies, New York City, New York, USA, p. 406\u2013407."},{"key":"S0924270817000126_ref48","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2012.06.022"},{"key":"S0924270817000126_ref73","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0b013e31815bfe2a"},{"key":"S0924270817000126_ref2","first-page":"10","article-title":"The definition and meaning of treatment-resistant depression","volume":"62","author":"Sackeim","year":"2001","journal-title":"J Clin Psychiatry"},{"key":"S0924270817000126_ref41","doi-asserted-by":"publisher","DOI":"10.1016\/j.brainresrev.2009.05.005"},{"key":"S0924270817000126_ref4","doi-asserted-by":"publisher","DOI":"10.2174\/138161206775474422"},{"key":"S0924270817000126_ref26","doi-asserted-by":"publisher","DOI":"10.1111\/j.1527-3458.2008.00043.x"},{"key":"S0924270817000126_ref42","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(99)00230-9"},{"key":"S0924270817000126_ref23","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0b013e31822a6b8e"},{"key":"S0924270817000126_ref60","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0b013e31824d1d02"},{"key":"S0924270817000126_ref40","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-013-1130-x"},{"key":"S0924270817000126_ref30","doi-asserted-by":"publisher","DOI":"10.1590\/S1516-44462008005000010"},{"key":"S0924270817000126_ref66","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-011-0205-7"},{"key":"S0924270817000126_ref51","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2011.12.010"},{"key":"S0924270817000126_ref15","first-page":"153","article-title":"ECT seizure therapeutic adequacy","volume":"10","author":"Krystal","year":"1994","journal-title":"Convuls Ther"},{"key":"S0924270817000126_ref80","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1177\/0310057X0403200509","article-title":"Adjustment of anaesthesia depth using bispectral index prolongs seizure duration in electroconvulsive therapy","volume":"32","author":"Nishihara","year":"2004","journal-title":"Anaesth Intensive Care"},{"key":"S0924270817000126_ref56","doi-asserted-by":"publisher","DOI":"10.1038\/mp.2013.87"},{"key":"S0924270817000126_ref58","doi-asserted-by":"publisher","DOI":"10.1517\/13543784.2014.918951"},{"key":"S0924270817000126_ref1","doi-asserted-by":"publisher","DOI":"10.1038\/475027a"},{"key":"S0924270817000126_ref11","doi-asserted-by":"publisher","DOI":"10.1159\/000119473"},{"key":"S0924270817000126_ref62","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1177\/0310057X1204000214","article-title":"Ketofol (mixture of ketamine and propofol) administration in electroconvulsive therapy","volume":"40","author":"Erdogan Kayhan","year":"2012","journal-title":"Anaesth Intensive Care"},{"key":"S0924270817000126_ref53","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.63.8.856"},{"key":"S0924270817000126_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(96)02844-2"},{"key":"S0924270817000126_ref6","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0b013e3181a74368"},{"key":"S0924270817000126_ref10","first-page":"25","article-title":"Disconnection of electroencephalographic, motoric, and cardiac evidence of ECT seizure","volume":"12","author":"Swartz","year":"1996","journal-title":"Convuls Ther"},{"key":"S0924270817000126_ref86","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1984.tb02475.x"},{"key":"S0924270817000126_ref52","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2012.10.019"},{"key":"S0924270817000126_ref47","doi-asserted-by":"publisher","DOI":"10.1017\/S1461145713000485"},{"key":"S0924270817000126_ref61","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-012-1378-6"},{"key":"S0924270817000126_ref5","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.57.6.581"},{"key":"S0924270817000126_ref45","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2011.338"},{"key":"S0924270817000126_ref50","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2012.08.040"},{"key":"S0924270817000126_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/0006-3223(93)90089-V"},{"key":"S0924270817000126_ref3","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v67n1203"},{"key":"S0924270817000126_ref7","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0b013e31825927a2"},{"key":"S0924270817000126_ref63","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-013-0420-5"},{"key":"S0924270817000126_ref24","doi-asserted-by":"publisher","DOI":"10.1097\/00124509-199806000-00005"},{"key":"S0924270817000126_ref16","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1176\/ajp.141.10.1269","article-title":"Duration of ECT-induced tachycardia as a measure of seizure length","volume":"141","author":"Larson","year":"1984","journal-title":"Am J Psychiatry"},{"key":"S0924270817000126_ref67","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-540-74806-9_13"},{"key":"S0924270817000126_ref69","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0b013e3182182be0"},{"key":"S0924270817000126_ref70","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0000000000000157"},{"key":"S0924270817000126_ref71","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0000000000000212"},{"key":"S0924270817000126_ref72","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0b013e31821072d2"},{"key":"S0924270817000126_ref74","doi-asserted-by":"publisher","DOI":"10.1177\/147323000803600103"},{"key":"S0924270817000126_ref39","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2015.05.010"},{"key":"S0924270817000126_ref75","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2006.01160.x"},{"key":"S0924270817000126_ref76","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0b013e3181df4ebb"},{"key":"S0924270817000126_ref78","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1055\/s-0032-1331748","article-title":"Bispectral index monitoring and seizure quality optimization in electroconvulsive therapy","volume":"46","author":"Kranaster","year":"2013","journal-title":"Pharmacopsychiatry"},{"key":"S0924270817000126_ref79","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000105874.50605.3C"},{"key":"S0924270817000126_ref81","doi-asserted-by":"publisher","DOI":"10.1023\/A:1009975701184"},{"key":"S0924270817000126_ref77","doi-asserted-by":"publisher","DOI":"10.1055\/s-2006-950395"},{"key":"S0924270817000126_ref82","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aen403"},{"key":"S0924270817000126_ref83","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0b013e318235b658"},{"key":"S0924270817000126_ref84","doi-asserted-by":"publisher","DOI":"10.1016\/0010-440X(72)90029-6"},{"key":"S0924270817000126_ref85","doi-asserted-by":"crossref","first-page":"1507","DOI":"10.1176\/ajp.136.12.1507","article-title":"The psychiatric use of electrically induced seizures","volume":"136","author":"Weiner","year":"1979","journal-title":"Am J Psychiatry"},{"key":"S0924270817000126_ref87","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-011-0240-4"},{"key":"S0924270817000126_ref49","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2013.13030392"},{"key":"S0924270817000126_ref89","volume-title":"American Psychiatric Association Committee on electroconvulsive therapy. The practice of electroconvulsive therapy: recommendations for treatment, training, and privileging","author":"Weiner","year":"2001"},{"key":"S0924270817000126_ref90","doi-asserted-by":"publisher","DOI":"10.1177\/070674379604100507"},{"key":"S0924270817000126_ref8","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0b013e31818a0203"},{"key":"S0924270817000126_ref46","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2014.03.026"},{"key":"S0924270817000126_ref64","doi-asserted-by":"publisher","DOI":"10.1097\/YCT.0000000000000109"},{"key":"S0924270817000126_ref43","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2009.08.038"},{"key":"S0924270817000126_ref88","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.03335"},{"key":"S0924270817000126_ref17","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-198612000-00017"}],"container-title":["Acta Neuropsychiatrica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0924270817000126","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T03:40:17Z","timestamp":1658979617000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0924270817000126\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5,2]]},"references-count":91,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,4]]}},"alternative-id":["S0924270817000126"],"URL":"https:\/\/doi.org\/10.1017\/neu.2017.12","relation":{},"ISSN":["0924-2708","1601-5215"],"issn-type":[{"value":"0924-2708","type":"print"},{"value":"1601-5215","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,5,2]]},"assertion":[{"value":"\u00a9 Scandinavian College of Neuropsychopharmacology 2017\u00a0","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}