{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T17:17:54Z","timestamp":1783703874880,"version":"3.55.0"},"reference-count":41,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacopsychiatry"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction The effectiveness of ECT relies on the induction of a\n                    generalized cerebral seizure. Among others, seizure quality (SQ) is potentially\n                    influenced by the anesthetic drug used. Commonly used anesthetics comprise\n                    barbiturates, etomidate, propofol, and esketamine, with different\n                    characteristics and impacts on seizure parameters. So far, no studies have\n                    compared the influence of methohexital vs. a combination of\n                    propofol\/esketamine on established SQ parameters.<\/jats:p><jats:p>\n          Methods This retrospective longitudinal study compared eight established\n                    SQ parameters (PSI, ASEI, MSC, midictal amplitude, motor and\n                    electroencephalography (EEG) seizure duration, concordance, PHR) before and\n                    after the change from propofol\/esketamine to methohexital in 34 patients\n                    under maintenance ECT. Each patient contributed four measurements, two before\n                    and two after the anesthesia change. Anesthesia dose, stimulus dose, electrode\n                    placement, and concomitant medication remained unchanged throughout the analyzed\n                    treatments.<\/jats:p><jats:p>\n          Results Under methohexital (M=88.97\u2009mg), ASEI\n                        (p=0.039 to 0.013) and midictal amplitude\n                    (p=0.022 to&lt;0.001) were significantly lower, whereas\n                    seizure duration (motor and EEG) was significantly longer when compared to\n                    propofol\/esketamine\n                    (M=64.26\u2009mg\/51.18\u2009mg; p=0.012\n                    to&lt;0.001). PSI, MSC, seizure concordance, and PHR were not affected by\n                    the anesthetic used.<\/jats:p><jats:p>\n          Discussion Although to what extent these parameters correlate with the\n                    therapeutic effectiveness remains ambiguous, a decision for or against a\n                    particular anesthetic could be considered if a specific SQ parameter needs\n                    optimization. However, no general superiority for one specific substance or\n                    combination was found in this study. In the next step, anesthetic effects on\n                    treatment response and tolerability should be focused on.<\/jats:p>","DOI":"10.1055\/a-2058-9010","type":"journal-article","created":{"date-parts":[[2023,4,28]],"date-time":"2023-04-28T22:59:36Z","timestamp":1682722776000},"page":"141-148","source":"Crossref","is-referenced-by-count":3,"title":["Effects of Anesthesia Changes During Maintenance ECT: A Longitudinal\n                    Comparison of Seizure Quality Under Anesthesia Using Propofol\/Esketamine\n                    Versus Methohexital"],"prefix":"10.1055","volume":"56","author":[{"given":"Isabel","family":"Methfessel","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University Medical Center\n                    G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Zilles-Wegner","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University Medical Center\n                    G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Kunze-Szikszay","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University Medical Center\n                    G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Belz","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University Medical Center\n                    G\u00f6ttingen, G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,4,28]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1097\/00124509-200403000-00004","article-title":"Efficacy of ECT in depression: A meta-analytic review","volume":"20","author":"D Pagnin","year":"2004","journal-title":"J ECT"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1176\/appi.ajp.2014.13060787","article-title":"Electroconvulsive therapy augmentation in clozapine-resistant schizophrenia: A\n                    prospective, randomized study","volume":"172","author":"G Petrides","year":"2015","journal-title":"Am J Psychiatry"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1016\/S0140-6736(03)12705-5","article-title":"Efficacy and safety of electroconvulsive therapy in depressive disorders: A\n                    systematic review and meta-analysis","volume":"361","author":"UK ECT Review Group","year":"2003","journal-title":"The Lancet"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1097\/YCT.0000000000000274","article-title":"Seizure adequacy markers and the prediction of electroconvulsive therapy\n                    response","volume":"32","author":"A Minelli","year":"2016","journal-title":"J ECT"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1046\/j.1440-1614.2003.01183.x","article-title":"A naturalistic study of the measurement of seizure adequacy in electroconvulsive\n                    therapy","volume":"37","author":"M Edwards","year":"2003","journal-title":"Aust N Z J Psychiatry"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1007\/s00406-018-0910-6","article-title":"A novel Seizure Quality Index based on ictal parameters for optimizing clinical\n                    decision making in electroconvulsive therapy. 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Part 2: Validation","volume":"268","author":"L Kranaster","year":"2018","journal-title":"Eur Arch Psychiatry Clin Neurosci"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1097\/01.yct.0000263254.21668.f0","article-title":"Seizure length in electroconvulsive therapy as a function of age, sex, and\n                    treatment number","volume":"23","author":"J J Rasimas","year":"2007","journal-title":"J ECT"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1111\/acps.13075","article-title":"Electroconvulsive therapy in bipolar depression - effectiveness and prognostic\n                    factors","volume":"140","author":"K Popiolek","year":"2019","journal-title":"Acta Psychiatr Scand"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00003643-200301000-00001","article-title":"Anaesthetic agents in adult day case surgery","volume":"20","author":"B J Pollard","year":"2003","journal-title":"Eur J Anaesthesiol"},{"key":"ref42","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1097\/00000539-200104000-00027","article-title":"The effects of propofol in the area postrema of rats","volume":"92","author":"D F Cechetto","year":"2001","journal-title":"Anesth Analg"}],"container-title":["Pharmacopsychiatry"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2058-9010.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T23:44:59Z","timestamp":1689291899000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2058-9010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,28]]},"references-count":41,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2023,7,12]]},"published-print":{"date-parts":[[2023,7]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2058-9010","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0176-3679","1439-0795"],"issn-type":[{"value":"0176-3679","type":"print"},{"value":"1439-0795","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,28]]}}}