Patients' physical response to thiopental and alternative anesthetic agents in the setting of electroconvulsive therapy.

Drug shortages continue to be at the forefront of health care concerns.1,2Thiopental, an agent used for anesthesia during electroconvulsive therapy (ECT), became unavailable in North America in August 2010. The sole producer of this drug, Hospira (headquartered in Lake Forest, Illinois), ceased production because of liability concerns if thiopental were used via lethal injection to enforce the death penalty.3 The thiopental shortage altered the practice of ECT, forcing a shift to alternative anesthetics. Of concern were the potentially negative consequences of using alternative agents, such as decreased efficacy and increased incidence of adverse effects.2 This study examined ECT session outcomes, relative to recommended criteria for ECT (as described in Appendix 1), to compare patients’ experiences during ECT performed with thiopental (the main anesthetic agent used in 2009) and their experiences during ECT performed with prescriber-selected alternatives used in 2011, when thiopental was in shortage.