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Methohexital and Succinylcholine Dosing for Electroconvulsive Therapy (ECT): Actual Versus Ideal

Bryson, Ethan O. MD*†; Aloysi, Amy S. MD; Popeo, Dennis M. MD; Bodian, Carol A. DrPH*; Pasculli, Rosa M. BA; Briggs, Mimi C. BA; Kellner, Charles H. MD

doi: 10.1097/YCT.0b013e3182503bc9
Online Articles

This report compares the actual doses of methohexital and succinylcholine used for optimal anesthesia and muscle relaxation in electroconvulsive therapy with written guidelines for dosing. The initial doses of methohexital and succinylcholine in milligrams per kilogram were reviewed and compared with subsequent doses of each agent after adjustments were made for individual patient responses during treatment. The dose of methohexital required to induce general anesthesia for most patients is 1.0 mg/kg. The dose of succinylcholine required to provide adequate muscle relaxation during electroconvulsive therapy is 0.9 mg/kg, although there is considerable variability in patient response to this drug.

From the Departments of *Anesthesiology and †Psychiatry, Mount Sinai School of Medicine, New York, NY.

Received for publication October 6, 2011; accepted October 7, 2011.

Reprints: Ethan O. Bryson, MD, Department of Anesthesiology, Mount Sinai Hospital, One Gustave L Levy Place, New York, NY 10029 (e-mail:

The authors have no conflict of interest to declare.

Support was provided solely from institutional and departmental sources.

© 2012 by Lippincott Williams & Wilkins