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July 1963

Sensitivity to Succinylcholine: Biochemical and Clinical Studies

Author Affiliations

From the Division of Psychiatry, Department of Medicine, University Hospitals of Cleveland, and Western Reserve University School of Medicine.
Associate Professor of Medicine and Pharmacology in the Division of Psychiatry, University Hospitals of Cleveland and Western Reserve University School of Medicine (Dr. Bidder); Teaching Fellow in Psychiatry, Western Reserve University School of Medicine (Dr. Sattin); Fellow in Child Psychiatry, Western Reserve University School of Medicine (Dr. Dowling).

Arch Gen Psychiatry. 1963;9(1):96-101. doi:10.1001/archpsyc.1963.01720130098012

Introduction  More succinylcholine (SDC)* is used today by psychiatrists than by any other group of physicians except anesthesiologists. It has been established that SDC modification of electroconvulsive therapy (ECT) reduces the intensity of the cardiovascular strain and the incidence of bone fractures and hypoxia ordinarily associated with this procedure.1,2 A major advantage that has accrued from the reduction of these troublesome complications is the increased use of ECT with older and poor-risk patients for whom it was previously contraindicated. In addition, the relaxed SDC-treated patient is easily oxygenated by bag breathing which reduces the danger of hypoxia, a potential cause of brain damage and cardiac arrest.In spite of the widespread acceptance of SDC modification, some psychiatrists prefer, in many cases, to give ECT without this muscle relaxant.3,4 The mortality rate with unmodified ECT has been consistently low (0.08% or less) despite an equally consistent, but disturbing,