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Abstract
Propofol is a new anesthetic induction agent that reduces electroconvulsive therapy
(ECT) seizure duration. To indirectly investigate the effect of propofol on ECT-induced
acute central neurotransmitter changes, we studied neuroendocrine responses in 25
primary depressed subjects treated with ECT under either propofol or thiopentone anesthesia.
Blood samples were taken prior to ECT, and then at regular intervals for 2 hr. Only
the prolactin response correlated significantly with seizure duration (r = 0.52, p < 0.01). Subjects given propofol had significantly reduced adrenocorticotropin (ACTH)
(p < 0.01) and cortisol (p < 0.05) responses compared to thiopentone, which were independent
of seizure duration. There was a trend towards a reduction in the prolactin response
with propofol compared to thiopentone, but this was dependent upon the diminished
seizure duration. The results indicate that propofol effects endocrine responses to
ECT by two distinct mechanisms: decreasing prolactin by reducing the seizure duration
and decreasing ACTH and cortisol by another process, possibly via a reduction in central
noradrenergic activation.
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Article info
Publication history
Received in revised form:
February 12,
1990
Received:
November 18,
1989
Footnotes
☆Supported in part by the Australian National Health and Medical Research Council.
Identification
Copyright
© 1990 Published by Elsevier Inc.