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May 24, 2026BMC PsychiatryOpen Access

Seizure adequacy and safety of remimazolam in electroconvulsive therapy for patients with psychiatric disorders: a double-blind randomized crossover trial

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Authors

TSTianqi ShenXYXingxing YinYZYongming Zhang

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Overview

Randomized trial compares remimazolam and propofol for seizure quality in psychiatric patients, suggesting important safety considerations.

Key Points

  • This research aims to evaluate the efficacy and safety of remimazolam compared to propofol in electroconvulsive therapy (ECT).
  • Conducted as a double-blind, randomized, crossover trial in hospitalized patients undergoing ECT.
  • Participants received either remimazolam (0.2 mg/kg) or propofol (2 mg/kg) for anesthesia induction in a crossover design.
  • Analyzed seizure duration and safety using generalized linear mixed-effects models.
  • Remimazolam group had longer EEG seizure duration (37.0 s vs. 18.5 s; p < 0.001) and EMG seizure duration (15.0 s vs. 9.0 s; p < 0.001).
  • Higher average seizure energy index with remimazolam (24,767.4 µV² vs. 15,702.7 µV²; p < 0.001).
  • Increased incidence of hypertension and tachycardia post-ictally with remimazolam.

Cite This Study

Shen et al. (2026) studied this question.

synapsesocial.com/papers/6a12969048a0ea1665673683https://doi.org/10.1186/s12888-026-08202-x
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