The optimal combination of ECT with pharmacotherapy

Abstract

The main indications for the electroconvulsive therapy (ECT) - psychotropic drug combination are pharmacotherapy-resistant, severe schizophrenic or affective psychoses. In such instances, a careful evaluation of the possible interactions between ECT and psychotropic drugs should precede the initiation of treatment in order to prevent adverse side effects. In this respect, the issues to be considered include the impact of concomittant pharmacotherapy on the seizure parameters of the ECT as well as the efficacy of the combined treatment relative to ECT or pharmacotherapy administered alone. This paper reviews the current literature on the use of benzodiazepines, mood stabilizers, antidepressants, antipsychotics together with ECT with the aim of providing recommendations for clinical practice.