Intravenous Nitroglycerine in the Management of Posttreatment Hypertension during Electroconvulsive Therapy

Intravenous nitroglycerine is not described in the psychiatric literature for management of the inevitable and potentially dangerous pressor response encountered in electroconvulsive treatment. However, the anesthesia literature has documented the use of nitroglycerine for the management of similar catecholamine-based hypertension. Unlike other approaches, nitroglycerine creates a controlled, significant, brief vasodilatation after convulsive treatment accompanied by desirable coronary vasodilatation without increased cardiac stress. A review of a series of treatments in which this technique was used confirms the clinical efficacy and safety of this approach.