The Effect of Atropine on Post-ECT Bradycardia in Patients with Major Depressive Disorder

Background: Electroconvulsive therapy (ECT) is utilized for treatment of a range of psychiatric disorders including major depressive disorder (MDD). One of the major complications in using ECT is cardiovascular problems i.e., bradycardia. The present study was designed to investigate the effect of atropine on the pulse rate (PR) of the patients under treatment with ECT. Materials and Methods: In this randomized clinical trial, 30 patients with diagnosis of MDD who received atropine before ECT treatment (control group) were compared with 30 patients with the same diagnosis without receiving atropine (experimental group) under ECT treatment. Both groups received ECT under the same term and condition. The PR of the patients were recorded 7 times (twice before anesthesia and ECT and 5 fixed one min intervals immediately after receiving ECT); for 10 sessions of treatment with ECT (3 times a week). The results were analyzed using repeated measure analysis of variance. The PR under 50 was the cut off point for differentiating the patients suffering from bradycardia and those without it. Results: Slight increment in PRs for experimental group (patient who did not receive atropine) in contrast to control group were observed, but it did not reach a statistically significant level. The gender (male/female) did not have different PR. The age of the patients and initial PR (regarded as co-variances) did not show significant effect on PR for total sample. Conclusion: There seems to be not necessary to use atropine treatment for depressed patients receiving ECT.