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Electroconvulsive Therapy in Patients Taking Monoamine Oxidase Inhibitors

Dolenc, Tamara J. MD*; Habl, Samar S. MD*; Barnes, Roxann D. MD; Rasmussen, Keith G. MD*

Case Report

Concerns have been expressed regarding the use of general anesthesia for electroconvulsive therapy (ECT) in patients taking monoamine oxidase inhibitors (MAOIs). We review the published literature and present 4 new cases and conclude that there is no evidence of a dangerous interaction between ECT and MAOI use. In general, a cautious approach would be to discontinue MAOIs before ECT if the medication has not been helpful; however, there is no need for a washout interval before starting ECT. Furthermore, if there is otherwise a reason for continuing the MAOI, it can be continued during index ECT or initiated during maintenance ECT.

From the *Department of Psychiatry and Psychology and †Department of Anesthesiology Mayo Clinic College of Medicine Rochester, Rochester, Minnesota.

Received for publication April 8, 2004; accepted May 3, 2004.

Reprints: Keith G. Rasmussen, Department of Psychiatry and Psychology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905 (e-mail:

© 2004 Lippincott Williams & Wilkins, Inc.