Intra-individual open comparison of burst-suppression-isoflurane-anaesthesia versus electroconvulsive therapy in the treatment of severe depression.
Isoflurane anaesthesia was proposed instead of electro-convulsive therapy (ECT) in patients with treatment-refractory depression. This open study compared burst-suppression-isoflurane-anaesthesia (BSIA) and ECT in 12 severely depressed patients. A series of 6 BSIA was administered in every patient. If improvement was insufficient or only temporary, a series of up to 12 ECT was given. A marked improvement of the depression was shown after both BSIA and ECT. Three patients were discharged from hospital after BSIA, nine patients were treated with BSIA and then ECT. The therapeutic effect of both regimens was equal as evidenced by the Hamilton-depression-rating-scale, a visual-analog-scale and the clinical global impression. BSIA requires more time and monitoring than ECT. Our exclusions of coronary, cerebral and peripheral vascular disease, untreated hypertension and focal neurological disease are strongly recommended. Due to the ease of application, ECT remains the standard treatment in depressed patients, but we consider BSIA a valuable alternative at least in patients who object to ECT.
Engelhardt
W
W
Institute of Anaesthesiology, University of Würzburg, Germany.
Carl
G
G
Hartung
E
E
D000328:Adult; D000368:Aged; D000647:Amnesia / Q000209:etiology; D000769:Anesthesia, Inhalation; D000928:Antidepressive Agents; D001145:Arrhythmias, Cardiac / Q000139:chemically induced; D001714:Bipolar Disorder / Q000188:drug therapy / Q000628:therapy; D001794:Blood Pressure / Q000187:drug effects; D003131:Combined Modality Therapy; D003702:Delusions / Q000188:drug therapy / Q000628:therapy; D003866:Depressive Disorder / Q000188:drug therapy* / Q000628:therapy*; D004562:Electrocardiography / Q000187:drug effects*; D004565:Electroconvulsive Therapy / Q000009:adverse effects; D005260:Female; D006212:Hallucinations / Q000188:drug therapy / Q000628:therapy; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D011446:Prospective Studies
D000928:Antidepressive Agents; D007530:Isoflurane