Abstract
Electric convulsive therapy (ECT) on which psychosomatic therapy was based, was replaced by psychotropic agents since it was invasive and caused noticeable defects of memory and occasionally irreversible damage. It is true, however, that ECT is very effective in some cases.
Forty-nine cases, who were hospitalized in psychiatric ward of the National Medical Center from 1963 to 1966, underwent 304 ECTs by the auricle application and 86 ECTs by the forehead application using muscle relaxants, general anesthesia by intubation and artificial respiration. The following results were obtained from electrocardiographic records taken immediately after stimulation, In the group which was not pretreated with atropine sulfate, cardiac arrest, block, auricular fibrillation and ventricular extrasystole occurred with frequencies of 45.4%, 68.0%, 9.1% and 81.8% respectively. Pretreatment with 0.5 mg of atropine reduced these frequencies to 0%, 26.3%, 0% and 52.6%. Various other types of arrhythmia were also clearly reduced in frequency by pretreament with atropine.
ECT produced cardiac arrest followed by various type of arrhythmia including block and sinus tachycardia was observed in all cases. The most frequently occurring arrhythmia was extrasystole. All of these adverse reactions were transient and reversible. They were considered to be mostly parasympathetic-excited central arrhythmia which could be relieved by pretreatment with atropine.
It is assumed that ECT is safe and effective in some cases in the presence of atropine, however careful physical control is mandatory, since it may cause malignant syndrome and sudden death.
