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Pharmacological prevention of postictal agitation after electroconvulsive therapy-A systematic review and meta-analysis.
Feenstra, Thomas C; Blake, Yvonne; Hoogendoorn, Adriaan W; Koekenbier, Krista; Beekman, Aartjan T F; Rhebergen, Didi.
Afiliación
  • Feenstra TC; GGZ Centraal Mental Health Care, Amersfoort, Netherlands.
  • Blake Y; Mental Health Program, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
  • Hoogendoorn AW; GGZ Centraal Mental Health Care, Amersfoort, Netherlands.
  • Koekenbier K; Mental Health Program, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
  • Beekman ATF; Department of Psychiatry, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
  • Rhebergen D; GGZ InGeest Mental Health Care, Amsterdam, Netherlands.
Front Psychiatry ; 14: 1170931, 2023.
Article en En | MEDLINE | ID: mdl-37151968
Background: Postictal agitation (PIA) after electroconvulsive therapy (ECT) is a serious clinical problem estimated to occur in 7-36% of patients and recur in 19-54% of patients. PIA has the potential to cause dangerous situations for the patient and staff members aside from the financial impact. To date, it is unclear which pharmacological interventions should be used in the management of PIA. This study aimed to systematically review the (preventative) pharmacological treatment options for PIA after ECT. Method: A systematic search was done in PubMed, EMBASE, PsycINFO, and Web of Science from inception until 10 November 2022. We included randomized trials with any pharmacological intervention or comparison and a predefined outcome measure on PIA. Studies that solely included patients with neurodegenerative disorders or stroke were excluded. Data quality was assessed with the RoB2 and GRADE. Meta-analysis was performed if possible. This study was registered on PROSPERO under CRD42021262323. Results: We screened 2,204 articles and included 14 studies. Dexmedetomidine was investigated in 10 studies. Alfentanil, lignocaine, esmolol, midazolam, propofol, ketamine, haloperidol, and diazepam were each studied in only one study. Meta-analysis revealed an OR of 0.45 (0.32-0.63), a moderate effect size, in favor of dexmedetomidine than placebo to prevent PIA with very low heterogeneity (I2 = 0%). The certainty of the evidence was moderate. The other interventions studied were all found to have low certainty of evidence. Conclusion: For clinical practice, we believe that our results indicate that dexmedetomidine should be considered for the prevention of PIA in patients that have previously experienced PIA.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Systematic_reviews Idioma: En Revista: Front Psychiatry Año: 2023 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Systematic_reviews Idioma: En Revista: Front Psychiatry Año: 2023 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Suiza