What are the considerations for Electroconvulsive Therapy (ECT) in patients with glaucoma?

From the Research

Considerations for Electroconvulsive Therapy (ECT) in Patients with Glaucoma

• The primary concern for ECT in patients with glaucoma is the potential increase in intraocular pressure (IOP) during the treatment 1.
• A study found that ECT is associated with a brief rise in IOP, but the significance of this in glaucomatous patients is unknown 1.
• In one case, a patient with bilateral glaucoma underwent IOP monitoring during ECT, and the results showed a brief rise in IOP in one eye, but not the other 1.
• The rise in IOP was approximately 5 mm Hg and lasted for about 5 minutes before returning to baseline 1.
• The study suggests that in a glaucomatous patient controlled with medicines or surgery, ECT probably will not cause a significant rise in IOP 1.

Management of Glaucoma

• Various medications can be used to lower IOP in patients with glaucoma, including echothiophate iodide, pilocarpine, and timolol 2, 3, 4, 5.
• Echothiophate iodide has been shown to be effective in lowering IOP in patients with glaucoma, including those with pseudophakic and aphakic eyes 2, 4.
• The choice of medication depends on the individual patient's response and the presence of any side effects 3, 5.

Monitoring and Precautions

• Patients with glaucoma should be closely monitored during ECT, and their IOP should be checked before and after the treatment 1.
• The anesthesiologist and psychiatrist should be aware of the patient's glaucoma and take necessary precautions to minimize the risk of increased IOP during ECT 1.