Prolonged hypertension: A case report of a potential interaction between electroconvulsive therapy and venlafaxine

Electroconvulsive therapy is often given in addition to antidepressant drugs when there has been an inadequate response to the latter. In the case of tricyclic antidepressants and monoamine oxidase inhibitors, this is not regarded as a hazardous combination. Caution is however advised with selective serotonin re-uptake inhibitors, since there may be a prolongation of seizures. Cardiovascular complications resulting from the combination of ECT and antidepressant medication have not been previously reported. We report on a case of prolonged hypertension following ECT in a patient taking the serotonin and noradrenaline re-uptake inhibitor, venlafaxine. Possible mechanisms for this potentially very serious interaction are discussed.