title: Effectiveness and risks of combining antipsychotic drugs with electroconvulsive treatment.
abstract: BACKGROUND
  The simultaneous application of electroconvulsive therapy (ECT) and psychotropic drugs is based on sparse data. Despite this, and the restrictive approach of the Guidelines and Consensus is widespread in the usual care, it is widely practiced in routine clinical.
  
  
  METHODS
  We reviewed the results of search on the topic in MEDLINE, PsychINFO, EMBASE and Cochrane, and the main guidelines on the subject and analyzed for drug groups.
  
  
  RESULTS
  Except some reservation with regard to classical MAOIs, antidepressants are safe and effective enhancers of the TEC. It is desirable to discontinuation of BZD whenever clinically possible before the course of ECT for risk of interference, if not possible will have to use proper technique to ensure effective incentives. It is advisable to stop or reduce the dose of lithium prior to ECT based on a cost-benefit analysis of the risk of relapse, if maintained will be adjusted lower levels and cognitive effects minimizing techniques. The combination with "classic" and "atypical" antipsychotics power positive clinical effects and the risk of combined use is low. The positive data are collected with clozapine and ECT-resistant psychosis, with little presence of effects of the decrease of seizure threshold by clozapine, and important effect of empowerment, but of limited duration.
  
  
  CONCLUSIONS
  Although it is strictly necessary to identify situations in terms of drugs, patient and ECT technique, and care necessary to develop tests that provide methodologically sound data, the combined use of ECT and psychotropic drugs in general presents an acceptable risk level and efficacy data by encouraging empowerment.
authors: Servicio de Psiquiatría, Hospital 12 de Octubre, Madrid, España. Electronic address: javisanz@terra.es.
authors: Francisco Javier
authors: FJ
authors: Sanz-Fuentenebro
authors: Ignacio
authors: I
authors: Vidal Navarro
authors: Daniel
authors: D
authors: Ballesteros Sanz
authors: Ernesto
authors: E
authors: Verdura Vizcaíno