Depression Clinical Trial
Official title:
Comparison of Thiopental and Propofol as Anaesteticum During ECT
Electroconvulsive therapy is the most effective treatment in severe depression and the
effect is related to the generalized seizure induced by the treatment. General anesthesia is
used during the treatment. Since only a brief period of unconsciousness is required
anesthetics with a rapid recovery profile are used.
Methohexital, a barbiturat, is internationally considered "the golden standard", bot other
short-acting anesthetics are used. In Denmark the most frequent used anestheticum for ECT is
Thiopental, a barbiturat, but also Propofol, a non-barbiturat, is used in many psychiatric
departments.
Several studies have shown that Propofol reduce seizure duration in comparison with
barbiturates. So far, no studies have demonstrated any clinical implications of the reduced
seiziure duration. However, these studies have included rather few patiens, most have been
retrospective, and in the only prospective study conducted, uni-lateral ECT was used.
The aim of this study is to compare the clinical effect of ECT in patients anesthesized with
either Propofol or Thiopental. The hypothesis is that the shorter duration of seizures found
with Propofol as anestheticum will increase the number of treatments needed to clinial
respons. Furthermore we want to study differences in EEG-relate parameters previously shown
to have prognostic value. Hospitalized patients with major depression, who is to be treated
with ECT, are randomized to anesthizia with either Thiopental or Propofol. They are rated
with Hamilton depression scale and BDI before treatment, after six treatments and when
treatment is concluded. When treatment is ended the patients are furthermore rated with MMSE
to evaluate their degree of cognitive impairment.
n/a
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Treatment
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