Factors Associated With Postictal Agitation After Electroconvulsive Therapy

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.