title: Propofol for the management of emergence agitation after electroconvulsive therapy: review of a case series.
abstract: We report the successful use of propofol in the management of a case series (n = 10) of patients with severe, treatment-resistant, postictal agitation (PIA) in the setting of electroconvulsive therapy (ECT). Despite prior inadequate response to intravenous midazolam and other agents, propofol therapy was highly effective with good control of PIA achieved in all cases. Propofol was well tolerated with occasional, transient, and reversible drops in blood the pressure being the only adverse event noted. The administration of propofol was also versatile being effective, as either a bolus or a bolus followed by an infusion. It appeared to be synergistic with existing therapy. Although further study is needed, these results suggest that propofol may be a very valuable additional agent for the ECT clinician in the management of PIA, which is a common entity in the setting of ECT.
authors.affiliation: ECT Service and Training Program, Department of Psychiatry, Hospital of the University of Pennsylvania, Philadelphia, PA, USA. oreardon@mail.med.upenn.edu
authors.forename: John P
authors.initials: JP
authors.lastname: O'Reardon
authors.forename: Nadia
authors.initials: N
authors.lastname: Takieddine
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Datto
authors.forename: John G
authors.initials: JG
authors.lastname: Augoustides
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001714:Bipolar Disorder / Q000628:therapy; D003865:Major Depressive Disorder / Q000628:therapy; D004565:Electroconvulsive Therapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000627:therapeutic use*; D011595:Psychomotor Agitation / Q000188:drug therapy* / Q000209:etiology*; D011618:Psychotic Disorders / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D015742:Propofol