WE BEGAN the systematic evaluation of drug-modification in electroconvulsive treatment (ECT) with a study1 of the two rapid-acting barbiturates most commonly used for ECT induction, thiopental (Pentothal) sodium and sodium methohexital (Brevital Sodium). The electrocardiogram was used as the index of cardiovascular complication, and two series of patients receiving ECT were compared. ECT was induced with thiopental in one series, and with methohexital in the other series, of 500 consecutive treatments. Many more cardiac arrhythmias occurred with thiopental anesthetic induction, providing preliminary evidence that methohexital is safer, as well as more convenient, than thiopental for the induction of brief anesthesia in ECT.
A second study of methohexital and pentothal anesthetic induction for ECT confirmed these differences.2 With each patient serving as his own control while atropinization, muscle relaxation, and resuscitation were held constant, four experimental variables were
Pitts FN, Woodruff RA, Craig AG, Rich CL. The Drug Modification of ECTII. Succinylcholine Dosage. Arch Gen Psychiatry. 1968;19(5):595-598. doi:10.1001/archpsyc.1968.01740110083009