title: Combined use of labetalol and nifedipine in controlling the cardiovascular response from ECT.
abstract: Serious cardiac complications have been reported to occur in elderly depressed patients during a course of electroconvulsive therapy (ECT). As a result, cardiac medications are being used more often to dampen the cardiovascular response that occurs during an ECT treatment. Specifically, labetalol (a mixed alpha- and beta-blocker) has been shown to effectively control the heart rate during ECT. However, on occasion, patients may still exhibit sustained elevations of blood pressure during ECT when receiving labetalol. The optimum clinical management of these patients is unclear. The authors report on the safety and efficacy of combining nifedipine with labetalol to control blood pressure during ECT in ten elderly patients whose blood pressures were not adequately controlled by labetalol alone. No adverse effects were noted, nor did nifedipine appear to shorten seizure duration.
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St Louis MO.
authors.forename: G S
authors.initials: GS
authors.lastname: Figiel
authors.forename: B
authors.initials: B
authors.lastname: DeLeo
authors.forename: C F
authors.initials: CF
authors.lastname: Zorumski
authors.forename: K
authors.initials: K
authors.lastname: Baker
authors.forename: A
authors.initials: A
authors.lastname: Goewert
authors.forename: M
authors.initials: M
authors.lastname: Jarvis
authors.forename: D S
authors.initials: DS
authors.lastname: Smith
authors.forename: G
authors.initials: G
authors.lastname: Mattingly
authors.forename: J
authors.initials: J
authors.lastname: Ruwitch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000187:drug effects*; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy*; D004359:Drug Therapy, Combination; D015716:Electrocardiography, Ambulatory / Q000187:drug effects*; D004565:Electroconvulsive Therapy; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007741:Labetalol / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000008:administration & dosage*; D011292:Premedication; D011446:Prospective Studies
chemical_list: D009543:Nifedipine; D007741:Labetalol