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The Safety of ECT in Patients With Chronic Obstructive Pulmonary Disease

Received January 20, 2006; revised July 6, 2006; accepted July 12, 2006. From the Dept. of Psychiatry and Psychology; Dept. of Internal Medicine; Dept. of Anesthesiology, Division of Cardiovascular Anesthesiology, Mayo Clinic, Rochester, MN. Send correspondence and reprint requests to Keith G. Rasmussen, M.D. Mayo Clinic Dept. of Psychiatry and Psychology, 200 First St. SW, Rochester, MN 55905. e-mail: rasmussen.keith{at}mayo.edu
© 2008 The Academy of Psychosomatic Medicine

BACKGROUND: Electroconvulsive therapy (ECT) involves the administration of general anesthesia and assisted ventilation while the patient is apneic. OBJECTIVE: Care must be taken to screen for significant pulmonary dysfunction before treatment. Very little has been written about the safety and management strategy of ECT patients with chronic obstructive pulmonary disease (COPD). METHOD: In this retrospective chart review, authors describe their experience with patients in recent years who had this disorder and were treated with ECT. RESULTS: Authors list recommendations for the pre-ECT work up and anesthetic management during and after the treatments. CONCLUSION: Recent guidelines recommend administration of patients’ prescribed inhalers on the morning of ECT treatment. Also, caution is recommended when using ECT in patients taking theophylline because this drug has been associated with prolonged seizures and status epilepticus in these patients.

Key Words: Electroconvulsive Therapy • COPD

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