Key result
ECT coadministered with an antidepressant-ziprasidone-quetiapine combination maintains normal QTc intervals without cardiac adverse events.
Why the study?
The safety of coadministration of electroconvulsive therapy with antidepressants and atypical antipsychotics regarding QTc interval changes in severe major depression was unclear.
Does the coadministration of electroconvulsive therapy with an antidepressant-ziprasidone-quetiapine combination increase QTc interval or cause cardiac adverse events in female patients with severe treatment-resistant major depression?
Case Report (n=6)
Does the coadministration of electroconvulsive therapy with an antidepressant-ziprasidone-quetiapine combination increase QTc interval or cause cardiac adverse events in female patients with severe treatment-resistant major depression?
The coadministration of electroconvulsive therapy with antidepressants, ziprasidone, and quetiapine appears safe regarding QTc interval changes in a small series of patients with severe treatment-resistant depression.
No immediate practice change indicated; leaves open systematic safety evaluation of ECT with these agents.
Both old and newer antidepressants and some atypical antipsychotics, such as ziprasidone and quetiapine, used as augmentation agents in severe major depression, are known to increase corrected QT (QTc) interval. We investigated the safety of the coadministration of electroconvulsive therapy with an antidepressant-ziprasidone-quetiapine combination with respect to QTc interval in 6 female patients with severe major depression resistant to pharmacotherapy alone. Each patient underwent a series of 10 to 11 sessions of bilateral electroconvulsive therapy. Corrected QT intervals were calculated at baseline and several times up to 10 minutes after seizure cessation. Overall, QTc interval changes remained within normal limits, without the occurrence of any cardiac adverse events. Our findings suggest that the coadministration of these treatments might be safe, at least with respect to QTc interval changes.
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Oulis et al. (2010) conducted a case report in severe major depression resistant to pharmacotherapy alone (n=6). Electroconvulsive therapy with an antidepressant-ziprasidone-quetiapine combination was evaluated on Corrected QT (QTc) interval changes. Coadministration of electroconvulsive therapy with an antidepressant-ziprasidone-quetiapine combination resulted in QTc interval changes remaining within normal limits with no cardiac adverse events.
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