Abstract
Thirteen patients with treatment-resistant major depression were given venlafaxine, at doses ranging from 150 mg to 375 mg, combined with ECT. Propofol was used as an anesthetic. Ten of 13 (76.9%) were considered responsive to combined ECT-venlafaxine treatment, and positive responses were not associated with venlafaxine doses. An asystole episode was observed in 4 patients; these patients had received significantly higher doses of venlafaxine (P<0.01). Treatment seems to be safe at venlafaxine doses <300 mg/day. At higher doses, with propofol used as anesthetic, the possibility of asystole cannot be ruled out. A possible additive effect of high-dose venlafaxine and propofol-blocking sodium channels are discussed.
MeSH terms
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Aged
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Anesthetics, Intravenous / pharmacology
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Anesthetics, Intravenous / therapeutic use
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Antidepressive Agents, Second-Generation / therapeutic use*
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Cyclohexanols / administration & dosage
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Cyclohexanols / adverse effects
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Cyclohexanols / therapeutic use*
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Depressive Disorder, Major / drug therapy
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Depressive Disorder, Major / therapy*
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Drug Administration Schedule
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Electroconvulsive Therapy / methods*
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Female
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Heart Arrest / chemically induced
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Heart Arrest / drug therapy
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Heart Arrest / epidemiology
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Heart Rate / drug effects
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Humans
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Male
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Middle Aged
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Propofol / pharmacology
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Propofol / therapeutic use
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Retrospective Studies
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Sodium Channels / drug effects
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Venlafaxine Hydrochloride
Substances
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Anesthetics, Intravenous
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Antidepressive Agents, Second-Generation
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Cyclohexanols
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Sodium Channels
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Venlafaxine Hydrochloride
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Propofol