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Effect of Etomidate Versus Thiopental on Major Depressive Disorder in Electroconvulsive Therapy, a Randomized Double-Blind Controlled Clinical Trial

Abdollahi, Mohammad Hassan MD*; Izadi, Amir MD; Hajiesmaeili, Mohammad Reza MD; Ghanizadeh, Ahmad MD§; Dastjerdi, Ghasem MD; Hosseini, Habib Allah MD*; Ghiamat, Mohammad Mehdi MD; Abbasi, Hamid Reza MD*

doi: 10.1097/YCT.0b013e31822a6b8e
Original Studies

Background: Although the therapeutic effect of electroconvulsive therapy (ECT) on major depressive disorder is widely investigated, there is a gap in literature regarding the possible effects of the medications used for induction of anesthesia in ECT. To the best of the authors’ knowledge, this study is the first randomized double-blind clinical trial comparing the effect of etomidate and sodium thiopental on the depression symptoms in patients who have received ECT.

Methods: The participants of this study are 60 adult patients with major depressive disorder who were referred for ECT. They were randomly allocated into 1 of the 2 groups. One group received etomidate, and the other group received sodium thiopental, as medication for induction of anesthesia. All the patients received bilateral ECT. The outcomes measures included the Beck Depression Inventory score, seizure duration, and recovery duration after induction of anesthesia.

Results: The sex ratio and mean age were not different between the 2 groups. Linear regression analysis showed that etomidate decreased the depression score more than did sodium thiopental. Seizure duration in all of the sessions in the etomidate group was significantly higher than that of sodium thiopental group.

Conclusions: In conclusion, etomidate may improve major depressive disorder more than sodium thiopental in patients who are receiving ECT.

From the *Anesthesiology Department, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd; †Seyedoshohada Hospital, Kerman; ‡Ayatollah Khatami Hospital, Khatam; §Research Center for Psychiatry and Behavioral Sciences, Department of Psychiatry, Shiraz University of Medical Sciences, Shiraz; ∥Psychiatry Department, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd; and ¶Anesthesiology Department, Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran.

Received for publication April 28, 2011; accepted June 21, 2011.

Reprints: Ahmad Ghanizadeh, Research Center for Psychiatry and Behavioral Sciences, Department of Psychiatry, Hafez Hospital, Shiraz, Iran (e-mail: ghanizad@sina.tums.ac.ir).

There is no conflict of interest to be declared.

A.G. was involved in the statistical analysis design, statistical analysis, interpretation of the results, writing the first draft, and review and critique of the article. All of the other authors were involved in the research project conception and organization; statistical analysis design; execution, review and critique, and writing of the first draft; and review and critique of the article.

This study is registered at the Iranian Registry of Clinical Trials (IRCT registration no. IRCT201104123468N6).

© 2012 by Lippincott Williams & Wilkins