Can Patients Safely Undergo Electroconvulsive Therapy While Receiving Monoamine Oxidase Inhibitors?
A review of the experience of monoamine oxidase inhibitors (MAOI) and anesthesia finds few well-documented complications, although theoretic risks of cardiovascular reactions are discussed. Laboratory studies and actual case experiences of patients treated with electroconvulsive therapy (ECT) and MAOI suggest that the risks have been exaggerated. It is recommended that the anesthesia usually used for ECT-methohexital, succinylcholine, and optionally atropine or glycopyrrolate-may be safely given with careful blood pressure monitoring. If cardiovascular support is required, a direct-acting sympathomimetic should be administered.
Freese
Kenneth J.
KJ
Department of Anesthesiology, School of Medicine, State University of New York at Stony Brook, Stony Brook, New York, and Department of Anesthesiology, Nassau County Medical Center, East Meadow, New York, USA.