[Medication with flunitrazepam in electroconvulsive therapy]

Abstract

The electroconvulsive therapy (ECT) continues to be of use in the management of patients suffering from affective psychosis and some clinical forms of schizophrenia. The use of premedicated anaesthetic and miorelaxant drugs lessens the possibility of complications, but risks the induction of serious cardiorespiratory accidents. The flunitrazepam is a benzodiazepine with hypnotic, ansiolytic and miorelaxant properties, which has been used as an anaesthetic in major and minor surgery. 241 ECT were essayed on 28 psychotic patients and flunitrazepam induced deep sleep in 94.6% of the applications within 0.5 and 15 minutes after the intravenous injection, the required dose oscillating between 2 and 4 mg. In all the applications a generalized convulsive crisis was induced. No significant pulse variations, arterial pressure, nor respiratory frequency took place. Post ECT agitation appeared in 0.82%. The associated pharmacological therapy (neuroleptics, lithium salts) did not modify the effect of flunitrazepam. Nor did tolerancy to the drug appear.