Effects of Intravenous Thiopentone Versus Etomidate on Modified Electroconvulsive Therapy (MECT) in Patients With Major Depressive Disorder

Background and aim Electroconvulsive therapy (ECT) has a well-established role in the management of patients who do not respond to psychopharmacological treatment. The therapeutic effect of ECT on major depressive disorder is widely investigated; the search for an ideal induction agent for ECT is an ongoing process. The present study was conducted to compare the effects of 3 mg/kg of intravenous thiopentone versus 0.2 mg/kg of intravenous etomidate on modified electroconvulsive therapy (MECT) in patients with major depressive disorder. Methods The present study was carried out as a double-blinded randomized study on 40 patients diagnosed with major depressive disorder. The study was approved by the institutional ethics committee, and written informed consent from each patient was obtained before the study. A total of 40 patients were divided into two groups of 20 each by block randomization. Group A patients (n = 20) received IV etomidate 0.2 mg/kg. Group B (n = 20) patients received IV thiopentone 3 mg/kg. After induction and muscle relaxation, electrical stimulus was applied, and the duration of seizure quality was measured using the cuff method. Results All statistical tests were done with IBM SPSS Statistics for Windows, Version 24 (Released 2016; IBM Corp., Armonk, New York, United States). The average seizure duration was 54 seconds in group A (etomidate), and it was 42 seconds in group B (thiopentone). Etomidate showed longer seizure duration compared to thiopentone with a significant p-value of 0.001 using an independent-samples T-test. Conclusion Etomidate, as an induction agent for patients with major depressive disorder, showed good seizure quality compared to thiopentone.