title: Amlodipine and the Successful Management of Post-Electroconvulsive Therapy Agitation.
abstract: Electroconvulsive therapy (ECT) is a highly effective nonpharmacologic treatment for the management of depression and some other psychiatric disorders. Post-ECT agitation occurs in up to 12% of ECT treatments and is characterized by motor restlessness, irritability, disorientation, and panic-like behaviors. The severity of post-ECT agitation ranges from mild and self-limited to serious and severe forms requiring prompt medical intervention to protect the patient and the medical staff. In severe agitation medical management may be necessary which consists of using sedative agents, either benzodiazepines or propofol. The side-effects of these sedative agents, especially in the elderly population, necessitate finding ways that could help the prevention of the occurrence of agitation after ECT treatments. We report a 68-year-old female with major depression who was referred for ECT. She experienced severe post-ECT agitation requiring medical intervention after all ECT treatments. Administering of oral amlodipine (5 mg) one hour before ECT treatment successfully prevented the occurrence of post-ECT agitation in this patient. We briefly discuss the possible underlying mechanisms and pathophysiology of amlodipine in the prevention of post-ECT agitation.
authors.affiliation: Department of Anesthesiology, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran 1333715914, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Shahriari
authors.affiliation: Department of Obstetrics and Gynecology, Arash Hospital, Tehran University of Medical Sciences, Tehran 1653915981, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Khooshideh
authors.affiliation: Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran 1419733141, Iran.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Sheikh