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Related Experiment Video

Updated: Apr 27, 2026

Electroconvulsive Seizures in Rats and Fractionation of Their Hippocampi to Examine Seizure-induced Changes in Postsynaptic Density Proteins
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Etomidate is still a valid anesthetic for electroconvulsive therapy.

Philip Lebowitz1

  • 1From the Clinical Anesthesiology, Albert Einstein College of Medicine, and Division of General Anesthesiology, Montefiore Medical Center, Bronx, NY.

The Journal of ECT
|July 11, 2014
PubMed
Summary

Etomidate, used for anesthesia in electroconvulsive therapy, does not appear to cause lasting adrenal suppression. A pilot study found its safety profile comparable to methohexital, challenging previous concerns.

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Area of Science:

  • Anesthesiology
  • Endocrinology

Background:

  • Etomidate is an anesthetic induction agent linked to increased mortality and cardiovascular morbidity in surgical patients.
  • Concerns exist regarding etomidate's potential for adrenocortical suppression, even with single doses, impacting cortisol production.

Purpose of the Study:

  • To prospectively evaluate the safety and adrenocortical effects of etomidate when used as an anesthetic for electroconvulsive therapy (ECT).
  • To compare the steroid responses to etomidate with those of methohexital in ECT patients.

Main Methods:

  • A pilot study involving patients undergoing electroconvulsive therapy.
  • Prospective evaluation of etomidate's impact on adrenocortical function over multiple administrations.
  • Monitoring of cortisol production and recovery between treatments.

Main Results:

  • Etomidate administered three times weekly for ECT did not result in prolonged adrenocortical suppression.
  • Adrenocortical responses to etomidate were comparable to those observed with methohexital.
  • No patients exhibited evidence of cortisol deficiency during the study period.

Conclusions:

  • Concerns about etomidate's safety, particularly regarding adrenocortical suppression, appear unwarranted for its use in electroconvulsive therapy.
  • The findings suggest that etomidate can be safely used for ECT anesthesia without significant long-term endocrine side effects.
  • Methodological differences may explain discrepancies with previous retrospective studies on etomidate's safety.