Prolonged electroconvulsive therapy seizure in a patient taking ciprofloxacin

Electroconvulsive therapy (ECT) can be used for the treatment of mental disorders, either alone or along with psychotropic agents and/or drugs for other medical conditions. We present in this case report a patient with postpartum depression on ciprofloxacin therapy for a urinary tract infection. The seizure in the first ECT treatment lasted for 30 seconds. While under the care of ECT, the patient was diagnosed as having a urinary tract infection; therefore, ciprofloxacin therapy of 1000 mg/day was initiated. Her second ECT seizure, which was on the third day of ciprofloxacin therapy, was terminated with 3 mg of intravenous midazolam at the 150th second. The ciprofloxacin therapy was discontinued. The patient had not previous history of epilepsy, and the investigation results for the extended seizure were found to be normal. The ECT therapy was restarted 3 days later, and total of 8 treatments were completed, lasting 35-70 seconds. Because the first ECT lasted for 30 seconds and subsequent therapy, which was reinitiated 3 days after the discontinuation of ciprofloxacin, lasted no longer than 70 seconds, the extended seizure in this patient is thought to be related to ciprofloxacin.