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Factors Associated With Postictal Agitation After Electroconvulsive Therapy.

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Postictal agitation (PA) occurred in 14% of electroconvulsive therapy (ECT) patients. Longer seizure duration and waking time were key predictors of PA, highlighting the need for vigilant monitoring during ECT recovery.

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Area of Science:

  • Neurology
  • Psychiatry

Background:

  • Electroconvulsive therapy (ECT) is a vital treatment for severe mental health conditions.
  • Postictal agitation (PA) is a recognized complication following ECT.
  • Identifying predictors of PA can improve patient safety and care during ECT recovery.

Purpose of the Study:

  • To determine the incidence of postictal agitation (PA) in patients receiving acute electroconvulsive therapy (ECT).
  • To identify patient and treatment variables associated with the occurrence of PA.

Main Methods:

  • Retrospective chart review of patients undergoing acute ECT series.
  • PA was identified by the need for post-ECT sedative administration.
  • Statistical analysis of demographic, diagnostic, medication, and ECT variables.

Main Results:

  • Postictal agitation (PA) was observed in 22 out of 156 patients (14.1%).
  • Significant associations with PA included patient sex, weight, active substance use disorder, seizure duration, and waking time.
  • Seizure duration and waking time remained significant predictors after multivariable analysis.

Conclusions:

  • Clinical factors can help predict postictal agitation (PA) following electroconvulsive therapy (ECT).
  • Patients with greater weight, male sex, or active substance use disorder require careful monitoring for PA.
  • Vigilance for PA is crucial in patients experiencing longer seizures and waking times post-ECT.