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Updated: May 13, 2026

Pupillary Response as Assessment of Effective Seizure Induction by Electroconvulsive Therapy
Published on: April 11, 2019
Etomidate and seizure duration in electroconvulsive therapy: is there a dose-dependent relation?
Anouk van Lammeren1, Annemieke Dols, Peter M van de Ven
1Department of Old Age Psychiatry (GGZ in Geest VU University Medical Center), Amsterdam, The Netherlands.
This study found no significant clinical link between etomidate dose and seizure duration in electroconvulsive therapy (ECT). Higher etomidate doses slightly reduced adequate seizure chances but remained clinically insignificant.
Area of Science:
- Anesthesiology
- Neuroscience
- Psychiatry
Background:
- Electroconvulsive therapy (ECT) is a vital treatment for severe mental health conditions.
- Etomidate is an anesthetic used in ECT, and its effect on seizure duration needs clarification.
Purpose of the Study:
- To investigate the dose-dependent relationship between etomidate and seizure duration in ECT.
- To assess the clinical significance of etomidate dosage on motor and electroencephalogram (EEG) seizure parameters.
Main Methods:
- Retrospective analysis of 74 patients undergoing ECT with etomidate anesthesia.
- Mixed-effects and generalized estimating equation models were used to analyze seizure duration and adequacy in relation to etomidate dose (mg/kg).
Main Results:
- A weak, clinically insignificant negative association was observed between etomidate dose and seizure duration (max correlation -0.21).
- Increased etomidate dosage reduced the likelihood of adequate seizures (OR 0.68 per 0.1 mg/kg increase).
- At a maximum dose of 0.3 mg/kg, 94.1% of seizures were adequate.
Conclusions:
- No clinically relevant dose-dependent relationship exists between etomidate and seizure duration in ECT when administered per guidelines.
- Current international guidelines for etomidate use in ECT appear appropriate regarding seizure duration.
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