Electroconvulsive Therapy and Hyperventilation: A Narrative Review

Electroconvulsive therapy (ECT) is a non-pharmacological biological treatment method used to treat major depression, bipolar disorder, schizophrenia, catatonia, and some other psychiatric conditions. Despite its high effectiveness, it is often used when other methods, such as pharmacotherapy and psychotherapy, fail to improve treatment outcomes. The refinement of this particular therapy may increase the popularity of this method, and among the currently studied therapy modifiers is protocolised hyperventilation. Hyperventilation is implemented to improve ventilation and gas exchange, reduce shortness of breath, improve blood oxygenation, and prevent hypoxia. Research suggests that hyperventilation during ECT may prolong the duration of epileptic seizures, potentially enhancing the effectiveness of the therapy. However, research on hyperventilation during ECT still poses many questions regarding its benefits and side effects. Innovative studies on ECT with concomitant hyperventilation focus on monitoring parameters such as CO₂, EEG, and cardiovascular responses. Current research directions worth exploring also include the utilisation of modern ECT devices or determining the neurotrophin concentration to better understand the mechanism of action at the neurochemical level. The personalization of therapy, including adjustment of ECT parameters to patients' specific symptoms, can reduce the risk of failure and increase effectiveness.