Effects of clonidine on the hemodynamic changes of electroconvulsive therapy

Introduction: Electroconvulsive therapy (ECT) is an effective treatment for many psychological disorders, mainly major depression and schizophrenia which is often associated with some complications such as hypertension, tachycardia arrhythmia and even myocardial infarction. Various methods have been used for prevention or control of these cardiovascular side effects. The aim of this study was evaluating the effect of oral clonidine as premedication on hemodynamic response after ECT. Methods: This double-blind clinical trial was performed on 100 patients aged 15-50 years with ASA I and II who were candidates for ECT. Prior to ECT, patients were randomly divided to 2 equal groups. The first group (N=50) received oral clonidine and the second group (N=50) received placebo as premedication. After baseline measurement of heart rate, systolic and diastolic blood pressures, similar induction of anesthesia was done in both groups. Then ECT was induced. The patients heart rate, systolic and diastolic blood pressures were measured again 2 minutes after termination of convulsion. Data was analyzed by t-test p<0.05 was considered statistically significant. Results: Regarding age, sex and baseline hemodynamic parameters, the patients were similar in both groups. Mean systolic and diastolic blood pressures after ECT were significantly lower in clonidine group (p<0.05), but there was no significant difference between heart rate after ECT in the two groups. Conclusion: According to these results, we recommend usage of clonidine as premedication before ECT.