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Electroconvulsive therapy and antibiotics: a case report

Irving M Reti1, Dimitry S Davydow

  • 1Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA. imreti@jhmi.edu

The Journal of ECT
|December 20, 2007
PubMed

Insights

Fluoroquinolone antibiotics, like moxifloxacin, may prolong electroconvulsive therapy (ECT) seizures. This class of drugs should be avoided in patients undergoing ECT to prevent extended seizure durations.

Area of Science:

  • Neurology
  • Pharmacology
  • Infectious Diseases

Background:

  • Infections are frequent in hospitalized patients, often requiring antibiotic treatment.
  • Electroconvulsive therapy (ECT) is a medical procedure used for specific psychiatric conditions.
  • Managing comorbidities during ECT requires careful consideration of potential drug interactions.

Observation:

  • A case study involving an 82-year-old woman undergoing ECT is presented.
  • The patient was treated with moxifloxacin, a fluoroquinolone antibiotic, for a respiratory infection.
  • Previously, the patient tolerated ECT without complications.

Findings:

  • Introduction of moxifloxacin was associated with a significant prolongation of electroconvulsive seizure duration.
  • The prolonged seizure duration occurred despite the successful treatment of the patient's respiratory infection.
  • This observation aligns with existing evidence suggesting fluoroquinolones can lower the seizure threshold.

Implications:

  • Fluoroquinolone antibiotics may pose a risk for patients undergoing ECT due to their effect on seizure threshold.
  • Clinicians should exercise caution and consider alternative antibiotics in patients receiving ECT.
  • Further research is warranted to fully elucidate the interaction between fluoroquinolones and ECT.

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