Electroconvulsive Therapy During Anticoagulant Therapy

The safety of ECT in patients receiving anticoagulants is reviewed. In patients who failed to respond to drug therapy and in some whose cardiovascular conditions precluded the use of antidepressant drugs, the authors successfully carried out five courses of ECT in depressed patients maintained on anticoagulants. In three cases, heparin was used, blood coagulation values were closely monitored, and the dose of succinylcholine employed was increased to provide almost complete muscular paralysis during the seizure. In one patient, acenocoumarol was sustained. The authors conclude that ECT may be safely administered in the presence of anticoagulant drug therapy.