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Clinical Features and Predictors of Postictal Excitement
D. P. Devanand1, Kathleen M. Briscoe, Harold A. Sackeim
1Department of Biological Psychiatry, New York State Psychiatric Institute and College of Physicians and Surgeons of Columbia University, New York, New York, USA.
Convulsive Therapy
|January 1, 1989
Summary
Postictal excitement after electroconvulsive therapy (ECT) is not consistently observed. Benzodiazepines may not be routinely necessary for patients experiencing this side effect.
Area of Science:
- Neuroscience
- Psychiatry
- Clinical Medicine
Background:
- Postictal excitement is a potential adverse event following electroconvulsive therapy (ECT).
- Understanding the predictors and frequency of postictal excitement is crucial for patient management.
Purpose of the Study:
- To investigate the clinical features and occurrence of postictal excitement in patients undergoing ECT.
- To determine if early postictal excitement predicts its recurrence in subsequent ECT sessions.
Main Methods:
- A retrospective case-control study design was employed.
- 24 patients exhibiting postictal excitement were compared with 24 matched controls.
- Data on clinical outcomes, treatment parameters, and seizure characteristics were analyzed.
Main Results:
- No significant differences were found between excited and control groups in clinical outcome or treatment variables.
- Patients experiencing early postictal excitement did not consistently exhibit it in later treatments.
- Only a minority of excited patients experienced excitement after the first ECT, with an average occurrence of 34.3% per treatment.
Conclusions:
- Postictal excitement following ECT is not a persistent phenomenon for most patients.
- Routine prophylactic use of postseizure benzodiazepines may not be indicated for all patients who have once experienced postictal excitement.