Key result
Concomitant treatment with bupropion during electroconvulsive therapy resulted in a pharmacoresistant focal status epilepticus after the fourth session in a patient with refractory depression.
Why the study?
Does concomitant bupropion use during ECT increase the risk of status epilepticus in patients with depression?
Case Report (n=1)
Does concomitant bupropion use during ECT increase the risk of status epilepticus in patients with depression?
Concomitant use of bupropion during ECT may lower the seizure threshold and facilitate the induction of status epilepticus.
Suggests caution with bupropion during ECT; hypothesis-generating case leaves open need for prospective safety data.
Electroconvulsive therapy (ECT) is the most effective treatment for therapy-refractory depression. Usually, prior antidepressant medication will be continued during ECT. However, the seizure threshold may be influenced by psychotropic drugs. We report a patient who received right unilateral ECT under concomitant treatment with bupropion, a selective noradrenaline- and dopamine-reuptake inhibitor. After the fourth session, a focal status epilepticus occurred, which was pharmacoresistant for the duration of 12 days. We assume that the induction of a status may be facilitated by a lowering of the seizure threshold due to bupropion. An evaluation of drug therapy and control of EEG before and during ECT are recommended, especially when the drug treatment has an influence on the seizure threshold.
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Dersch et al. (2011) conducted a case report in Therapy-refractory depression (n=1). Electroconvulsive therapy (ECT) and concomitant bupropion was evaluated on Focal status epilepticus. Concomitant treatment with bupropion during electroconvulsive therapy resulted in a pharmacoresistant focal status epilepticus after the fourth session in a patient with refractory depression.
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