Medication Management During Electroconvulsive Therapy

Safety and Efficacy

• The American Academy of Child and Adolescent Psychiatry recommends continuing olanzapine and mirtazapine during ECT as part of the maintenance treatment strategy, which includes evaluation of cognition, mood, psychosis, and other psychiatric symptoms 3

Potential Side Effects

• Patients taking olanzapine and mirtazapine during ECT should be monitored for increased sedation or drowsiness, as well as orthostatic hypotension, particularly with olanzapine 1

Medications to Discontinue Before ECT

• Lithium, trazodone, carbamazepine, theophylline, and benzodiazepines should be discontinued prior to ECT due to risks such as acute brain syndrome, prolonged seizures, prevention of seizure induction, prolonged seizure duration, and increased seizure threshold, respectively 2