title: Propofol in the management of postictal delirium with clozapine-electroconvulsive therapy combination.
abstract: Postictal delirium is an acute confusional state occurring during the immediate postictal phase in patients receiving electroconvulsive therapy that is characterized by motor agitation, disorientation, clouded consciousness, repetitive stereotyped movements, and poor response to commands. A schizophrenic patient with severe and recurrent postictal delirium is described. The possible role of the clozapine-electroconvulsive therapy combination in the occurrence of postictal delirium is discussed. Several management strategies were tried, with various degrees of success. Propofol proved to be effective in preventing agitation when used as induction agent or when administered at seizure end. However, propofol could not prevent a delirious state when only administered after the first signs of motor restlessness had emerged.
authors.affiliation: ECT Department, University Center Sint-Jozef, Leuvensesteenweg, Kortenberg, Belgium. pascal.sienaert@uc-kortenberg.be
authors.forename: Pascal
authors.initials: P
authors.lastname: Sienaert
authors.forename: Filip
authors.initials: F
authors.lastname: Bouckaert
authors.forename: Isabel
authors.initials: I
authors.lastname: Fernandez
authors.forename: André
authors.initials: A
authors.lastname: Hagon
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Hagon
authors.forename: Jozef
authors.initials: J
authors.lastname: Peuskens
mesh_terms: D000328:Adult; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003024:Clozapine / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003693:Delirium / Q000188:drug therapy* / Q000209:etiology; D004565:Electroconvulsive Therapy; D006801:Humans; D008297:Male; D015742:Propofol / Q000008:administration & dosage*; D012559:Schizophrenia / Q000628:therapy*
chemical_list: D018686:Anesthetics, Intravenous; D014150:Antipsychotic Agents; D003024:Clozapine; D015742:Propofol