Departments of Psychiatry and Behavioral Sciences.
Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
J ECT. 2024 Mar 1;40(1):37-40. doi: 10.1097/YCT.0000000000000951. Epub 2023 Jul 20.
This study assessed the incidence of and risk factors for prolonged seizures (>180 sec) in electroconvulsive therapy (ECT).
In 611 adult patients undergoing 6697 ECT treatments administered over a 2.5-year study period, 29 individuals experienced 42 prolonged seizures. A comparison sample (n = 29) was matched on sex, age, and treatment, and compared on psychiatric and medical diagnoses, as well as current medications. To examine the association between the characteristics and prolonged seizure, conditional logistic regression models or exact McNemar tests were conducted.
Prolonged seizures occurred on average in 1 of every 167 treatments. No specific psychiatric disorders or medical conditions were associated with the prolonged seizure group. Antipsychotic drugs were used in a higher proportion of the comparison group than in the prolonged seizure group, suggesting a protective effect. Atropine was used in a lower proportion of the long seizure group than in the comparison group. No untoward sequelae occurred, and no progression to status epilepticus was observed.
Prolonged seizures appear to be an uncommon complication of ECT in adults. The characteristics examined in this study suggest limited association of psychotropic medications with prolonged seizures. Treatment of prolonged seizures was straightforward. Prolonged seizures had no impact on the course of treatment. Further exploration of prolonged seizures would enhance the generalizability of the findings from this single site study.
本研究评估了电抽搐治疗（ECT）中长时间发作（>180 秒）的发生率和危险因素。
在 611 名成年患者中，在 2.5 年的研究期间接受了 6697 次 ECT 治疗，29 名患者经历了 42 次长时间发作。通过比较性别、年龄和治疗情况，对一个匹配样本（n=29）进行了匹配，并比较了精神科和医学诊断以及当前药物治疗情况。为了检查特征与长时间发作之间的关系，进行了条件逻辑回归模型或精确 McNemar 检验。
平均每 167 次治疗中就会发生 1 次长时间发作。没有特定的精神障碍或医学状况与长时间发作组相关。与比较组相比，抗精神病药物在长时间发作组中使用的比例更高，表明具有保护作用。在长时间发作组中，阿托品的使用比例低于比较组。没有出现不良后果，也没有观察到癫痫持续状态的进展。
长时间发作似乎是成人 ECT 的一种罕见并发症。本研究中检查的特征表明，精神药物与长时间发作的相关性有限。长时间发作的治疗非常简单。长时间发作对治疗过程没有影响。进一步探讨长时间发作将增强来自单一地点研究的发现的普遍性。
