Selective disturbances of serum mineral profiles by electroconvulsive therapy

In nine patients with severe affective illness, the serum profiles of Mn, Zn, Cu, Mg, and Ca before and following successful bitemporal electroconvulsive therapy (ECT) were investigated. No elemental baseline abnormalities were detected before ECT. Both high and low level electric stimulation failed to produce changes in the serum concentrations of Mg as a function of time after ECT. Group mean concentrations of Zn, Cu, and Ca decreased after ECT, but values did not reach statistical significance. In contrast high level, but not low level, stimulation was accompanied by significant brief elevation of Mn (65%, p less than .02) followed by a progressive drop below basal levels (67%, p less than .001) 2 hours post-ECT. Similar patterns were observed during the middle and last ECT. Pre-ECT baseline Mn concentrations declined by about 44% (p less than .01) after the last ECT administration. The time course of these changes, in conjunction with evidence obtained from animal experimentation, suggests that high level ECT, irrespective of the onset of antidepressant effects, may alter extracellular Mn and consequently its normal intracellular composition as a result of the sudden increase in energy expenditure imposed by convulsive activity. Possible interactions between this element and other metabolic pathways are discussed. These changes may originate from elemental participation in restorative homeostatic metabolic processes during and after ECT.