Necessity of the time to recovery measurement in ECT

Abstract ECT (electroconvulsive therapy) is a safe treatment of the most severe neuropsychiatric diseases. However, sometimes complecated by transient cognitive impairment (TCI). The importance of individual current parameters (seizure threshold, seizure duration, frequency, current amplitude, duration of stimulation, and pulse width) has been taken into account. The time to reorientation (or time to recovery, TTR) is a very simple parameter to measure, which has predictive value for the TCI. With a concentration on minimalizing the TCI, we use ultra-brief pulses (0,3ms) in a right-unilateral setting in a depressed patient. Energy titration is a basic prerequisite for minimizing the dose of energy used to induce an adequate therapeutic seizure (measured by two-channel EEG; 20-60s of epileptiform activity). We observed 46 patients in 158 ECT sessions (of which 40,03 % were males) with a mean age of 50,74 years (median 54; SD 13,01) with various diagnoses (ICD-10) of non-psychotic depressive episodes. We excluded the titration (first) session of ECT from further statistical analysis. The average seizure lasted 31,14 sec (median 30; SD 17,04). The following time was measured since the press of the trigger. The average time to the first spontaneous opening of the eyes was 6,45 min (median 6; SD 2,16). The average time to full vigilance (Glasgow coma scale 4+5+6) was 9,32 min (median 9; SD 3,69). The average time to full lucidity (oriented in person, time, space, and situation) was 12,42 min (median 12; SD 4,996). Time to re-orientation (defined as the time from first eyes opening till full orientation) was 5,97 min (median 5; SD 4,13). Further research and perhaps correlation to other parameters is desirable. Supported by IGA-KZ-2022-1-4 and MH CZ-DRO VFN 64165. Research Category and Technology and Methods Clinical Research: 2. Electroconvulsive Therapy (ECT) Keywords: ECT, time to recovery