[Is it advisable to combine electroconvulsive therapy (ECT) with psychotropics?]

Psychotropic medication is sometimes tapered prior to electroconvulsive therapy (ECT) because of concern about interactions.

The published literature is reviewed to find grounds for these concerns.

ECT can be combined safely with most psychotropics. Combination treatment with lithium can cause complications, but termination of lithium is not always necessary. Combination treatment with venlafaxin in doses higher than 300 mg daily can cause serious complications.

The recommendation in the Dutch guidelines not to combine ECT with psychotropics because of possible interactions needs to be reconsidered. A specific recommendation is needed for each psychotropic medication.