Effects of oral clonidine on the hyper dynamic responded after electroconvulsive therapy

Background: Electroconvulsive therapy (ECT) is an effective treatment of major depression and
other psychological disorders especially resistant to medical therapy. ECT has some side effects
such as cardiac arrhythmia, hypertension. Myocardial infarction and cerebrovascular accident.
Therefore, prevention or attenuation of these hyper dynamic responses could decrease or prevent
side effects, though some medications have been used for hyper dynamic responses. In this study we
assessed oral clonidine (one α2 versus drug) as premedication on the hemodynamic responses of
ECT.
Methods and Materials: this clinical trial was designed as: randomly, double blind and crossover
study in which 37 patients of ASA class I and II were candidates for ECT in Baharan hospital
of Zahedan, received one of the three regimens of treatment as: placebo,100 and 200μg of
clonidine. We of course recorded heart rate (HR) and mean arterial pressure (MAP) before and
after ECT. Anaesthetic method was the same for all patients and at the end we could compare the
peak measured HR, and MAP with the baseline values.
Results: We found that oral clonidine could prevent tachycardia (P<0.001) and partially prevent
hypertension after ECT. However, convulsion time, spontaneous breathing and recovery time was
equal for all three groups.
Conclusions: Oral clonidine by easing stress and/or painful responses can stabilize
hemodynamics status specially HR after ECT. Though, the drug had no significant effect on
convulsion and recovery times whatsoever. Therefore, we would put forward usage of oral
clonidine as premedication for ECT particularly in patients with decreased cardiac reserve