ArticleEuropean archives of psychiatry and clinical neuroscience2026
Effect of ECT-anesthetics on reorientation time.
Article in European archives of psychiatry and clinical neuroscience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
Electroconvulsive therapy (ECT) remains one of the most effective treatments in psychiatry, but cognitive side effects still pose a clinical concern. Delayed postictal reorientation is linked to worse cognitive outcomes, adversely affecting patient-perceived treatment tolerability and acceptability, while also increasing post-ECT and post-anesthesia care demands. Despite its clear clinical and operational relevance, comparative evidence on anesthetic effects remains scarce. This study therefore investigates the impact of different anesthetic agents (S-ketamine, propofol, etomidate, thiopental, and the combination of S-ketamine and propofol) on reorientation time following ECT. Retrospective data from 5148 ECT sessions were analyzed using a linear mixed-effects model controlling for age, sex, diagnosis, stimulation dose, electrode placement, seizure quality, ECT session number, need for restimulation, ECT duration, and postictal agitation. Compared with S-ketamine, propofol reduced reorientation time by 6.2 min, and the combination of S-ketamine and propofol reduced reorientation time by 1.5 min. Neither thiopental nor etomidate differed significantly from S-ketamine. The differences may be attributed to the distinct pharmacodynamic profiles of the anesthetic agents. The findings demonstrate that anesthetic choice is a significant and independent determinant of reorientation time following ECT, with propofol and the combination of S-ketamine and propofol associated with markedly faster cognitive recovery compared to S-ketamine.
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