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Related Experiment Video

Updated: Apr 28, 2026

Electroconvulsive Seizures in Rats and Fractionation of Their Hippocampi to Examine Seizure-induced Changes in Postsynaptic Density Proteins
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Beta-blocking agents during electroconvulsive therapy: a review.

E Boere1, T K Birkenhäger2, T H N Groenland3

  • 1Department of Psychiatry, Erasmus Medical Centre, PO Box 2040, Rotterdam 3000 CA, The Netherlands e.boere@yahoo.com.

British Journal of Anaesthesia
|June 20, 2014
PubMed
Summary

Beta-blockers like esmolol and landiolol can manage cardiovascular effects during electroconvulsive therapy (ECT). Esmolol is effective, but higher doses may impact seizure duration, while landiolol requires further study on blood pressure effects.

Keywords:
adrenergic beta-antagonistselectroconvulsive therapyesmolollabetalollandiolol

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Area of Science:

  • Anesthesiology
  • Cardiology
  • Psychiatry

Background:

  • Electroconvulsive therapy (ECT) can cause transient hypertension and tachycardia.
  • Beta-blocking agents are considered for preventing cardiovascular complications during ECT.
  • These agents may also influence electroconvulsive seizure duration.

Purpose of the Study:

  • To review studies on beta-blocking agents used during ECT.
  • To determine which agent offers the most favorable outcomes for cardiovascular variables.
  • To assess the impact of beta-blockers on electroconvulsive seizure duration.

Main Methods:

  • Medline database search using keywords 'adrenergic beta-antagonists' and 'electroconvulsive therapy'.
  • Included only double-blind randomized controlled trials.
  • Analyzed 29 original studies.

Main Results:

  • Esmolol significantly attenuated cardiovascular parameters in the first 5 minutes post-stimulation; higher doses may affect seizure duration.
  • Labetalol showed inconsistent early cardiovascular effects, significant after 5 minutes; seizure duration data was limited.
  • Landiolol attenuated heart rate but had inconsistent effects on arterial pressure (AP); seizure duration was largely unaffected.

Conclusions:

  • Esmolol effectively reduces cardiovascular response to ECT, though higher doses might affect seizure duration.
  • Landiolol is a potential alternative, but its effects on AP warrant further investigation.
  • Labetalol has been less studied and may cause prolonged cardiovascular effects; further research on beta-blockers in ECT is needed.