The Effect of Magnesium Sulfate on Blood Pressure and Heart Rate After Electroconvulsive Therapy



Honarm A¹ ; Safavi SM¹ ; Salehi M² ; Habibzadeh M³ ; Masoudifar M¹ ; Nazem M⁴ ; Mehdizadeh F⁵ ; Barvarze S¹ Show Affiliations
Source: Journal of Isfahan Medical School Published:2013

Abstract

Background: Electroconvulsive therapy (ECT) is a medical treatment used in serious mental illnesses, in which a small amount of electricity passed the brain. The hemodynamic side effects include an initial parasympathetic response causing transient bradycardia, followed by a sympathetic discharge resulting in tachycardia, hypertension and a risk of arrhythmias. The aim of this study was to determine the effect of different doses of magnesium sulfate on cardiovascular response after electroconvulsive therapy. Methods: This clinical-trial, double-blind, randomized study was held cross over on 35 patients in electroconvulsive therapy (ECT) center of Noor hospital in Isfahan, Iran, in 2011. Each patient was randomly assigned to be allocated twice into each of the four test groups which received placebo (control) or 10 (first), 20 (second), or 30 (third) mg/kg of MgSO4. Systolic and diastolic arterial blood pressures, heart rate and oxygen saturation values were recorded on arrival for the ECT and then at 0, 1, 3 and 10 minutes after the end of the ECT-induced seizure. Findings: Mean systolic blood pressure at 0, 1 and 3 minutes after the end of the ECT-induced seizure of the second (126.140 ± 20.937, 122.710, ± 18.524, and 115.710 ± 17.504 mmHg, respectively) and third (123.000 ± 18.077, 123.710 ± 14.770, and 116.290 ± 14.201 mmHg, respectively) groups were statistically different compared to controls. Besides, mean diastolic blood pressure at 0, 1 and 3 minutes after the end of the ECT-induced seizure of the second group (76.000 ± 10.304, 74.430 ± 9.669, and 76.140 ± 9.082 mmHg, respectively) were statistically different compared to control group. Mean arterial blood pressure (MAP) at 0, 1 and 3 minutes after the end of the ECT of the second (92.140 ± 12.237, 90.710 ± 12.328, and 89.330 ± 12.425 mmHg, respectively) and third (91.670 ± 11.602, 90.860 ± 10.905, 89.520 ± 9.873 mmHg, respectively) groups compared with the control group were statistically different, too. Heart rate and arterial oxygen saturation at different times in the four groups were not statistically different. Conclusion: Based on the results of this study, magnesium sulfate with doses of 20 and 30 mg/kg attenuated the systolic and diastolic blood pressure and mean arterial blood pressure (MAP) response of electroconvulsive therapy without reducing the duration of seizure activity.