The role of atropine in electroconvulsive therapy

The practice of preparing patients about to undergo electroshock treatment with atropine has been re-examined in the light of the great variety of practices which prevail both in terms of dose, route of administration and timing of the drug, as reported in the literature. By using patients as their own controls in the course of a series of treatments, it was determined that there are no appreciable differences between intravenous atropine given in different doses at different times and no atropine at all. Since no evidence was found that atropine contributes to cardiovascular stability or to consistent drying of secretions, and since its omission was not accompanied by untoward effects, it is suggested that the agent is not needed nor even necessarily desirable as a premedicant in electroshock therapy.