Predictors of postictal delirium at 30 minutes after electroconvulsive therapy in Indian patients

Predictors of postictal delirium at 30 minutes after electroconvulsive therapy in Indian patients | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Predictors of postictal delirium at 30 minutes after electroconvulsive therapy in Indian patients Sonali Dagar, Vinod Daria, Usha Daria, Kuldeep Singh This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5375069/v2 This work is licensed under a CC BY 4.0 License Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Abstract Acute confusional state or delirium occurs in 12% of patients after receiving electroconvulsive therapy (ECT). This adverse effect can lead to falls and injuries in the recovery room. The duration of disorientation also predicts retrograde amnesia in patients. Knowing the predictors of postictal delirium after ECT will help optimize treatment and improve the safety of therapy in this part of the world, where ECT is still widely used for the treatment of psychiatric disorders and acute agitation and is increasingly becoming a daily care procedure. The aim of this study was to identify predictors of post-ECT delirium. We hypothesized that patient variables, type of general anesthesia and ECT treatment variables might influence the likelihood of delirium. Methodology: A prospective randomized study was conducted after registration with the Central Trial Registry of India via the Richmond Agitation-Sedation Scale and the Confusion Assessment Method for the Intensive Care Unit at 30 min after the first ECT treatment of 90 consecutive patients. Patients were randomized into three groups and received different anesthetic agents. We used the half-age dosing method for ECT, and patient variables were extracted via chart review. Variables, including the type of general anesthesia, ECT treatment parameters, age and biochemical parameters of the patient, were analyzed. Results: Postictal delirium was present in 10 patients (11.11%) at 30 minutes after ECT administration. No significant differences were observed in age, number of concomitant medications, anticholinergic cognitive burden, baseline biochemical characteristics, type of anesthesia, total charge, stimulus duration, or seizure length for electroconvulsive therapy between these two groups. Conclusion: The choice of anesthetic does not predict delirium after ECT. Long seizure duration is not a risk factor for prolonged disorientation after the administration of electroconvulsive therapy. Adequate seizure duration can be administered to patients with the choice of appropriate anesthetic agents for effective ECT without risk for post-ECT delirium. delirium electroconvulsive therapy postictal Full Text Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5375069","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":379262219,"identity":"f9566d9b-0233-4db6-8cfc-907ed782bbc0","order_by":0,"name":"Sonali Dagar","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+ElEQVRIiWNgGAWjYLCCBwYMjA0gxgcgZmMnRksCVAvjDJAWZqK0MEC0MPOAeIS0yLf3HvyQUMAg29+/+Nlnm1/b5PmYGRg/fMzBrcXgzLlkCaDDjGfceGY8O7fvtmEbMwOz5MxteLRI5BiAtCQ23DhgzJzbc5sRqIWNmRePFvkZOcY/QFrm3zj+mdmy57Y9QS0MN3LMwLZsON9jzMzw43YiQS0GZ86YWSQYSBhvvMFTzNjbcDu5jZmxGa9f5Nt7jG98+GMjO+/88c0MP/7ctp3f3nzww0d8DoMACSBKAMZOG4gDSQlEAP4DQOIPkYpHwSgYBaNgRAEArPBRPRqz1s4AAAAASUVORK5CYII=","orcid":"","institution":"Government Medical College, Kota","correspondingAuthor":true,"prefix":"","firstName":"Sonali","middleName":"","lastName":"Dagar","suffix":""},{"id":379262220,"identity":"2acf9606-d1a2-49a7-8598-4633c25721fc","order_by":1,"name":"Vinod Daria","email":"","orcid":"","institution":"Government Medical College, Kota","correspondingAuthor":false,"prefix":"","firstName":"Vinod","middleName":"","lastName":"Daria","suffix":""},{"id":379262221,"identity":"11bb5595-6f7b-49f1-a4a9-819965879e5e","order_by":2,"name":"Usha Daria","email":"","orcid":"","institution":"Government Medical College, Kota","correspondingAuthor":false,"prefix":"","firstName":"Usha","middleName":"","lastName":"Daria","suffix":""},{"id":379262222,"identity":"068cafb9-5a96-49c7-a2b1-aa122666992f","order_by":3,"name":"Kuldeep Singh","email":"","orcid":"","institution":"Government Medical College, Kota","correspondingAuthor":false,"prefix":"","firstName":"Kuldeep","middleName":"","lastName":"Singh","suffix":""}],"badges":[],"createdAt":"2024-11-01 18:23:11","currentVersionCode":2,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-5375069/v2","doiUrl":"https://doi.org/10.21203/rs.3.rs-5375069/v2","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[],"financialInterests":"The authors declare no competing interests.","formattedTitle":"Predictors of postictal delirium at 30 minutes after electroconvulsive therapy in Indian patients","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"delirium, electroconvulsive therapy, postictal","lastPublishedDoi":"10.21203/rs.3.rs-5375069/v2","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5375069/v2","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eAcute confusional state or delirium occurs in 12% of patients after receiving electroconvulsive therapy (ECT). This adverse effect can lead to falls and injuries in the recovery room. The duration of disorientation also predicts retrograde amnesia in patients. Knowing the predictors of postictal delirium after ECT will help optimize treatment and improve the safety of therapy in this part of the world, where ECT is still widely used for the treatment of psychiatric disorders and acute agitation and is increasingly becoming a daily care procedure.\u003c/p\u003e\n\u003cp\u003eThe aim of this study was to identify predictors of post-ECT delirium. We hypothesized that patient variables, type of general anesthesia and ECT treatment variables might influence the likelihood of delirium.\u003c/p\u003e\n\u003cp\u003eMethodology: A prospective randomized study was conducted after registration with the Central Trial Registry of India via the Richmond Agitation-Sedation Scale and the Confusion Assessment Method for the Intensive Care Unit at 30 min after the first ECT treatment of 90 consecutive patients. Patients were randomized into three groups and received different anesthetic agents. We used the half-age dosing method for ECT, and patient variables were extracted via chart review. Variables, including the type of general anesthesia, ECT treatment parameters, age and biochemical parameters of the patient, were analyzed.\u003c/p\u003e\n\u003cp\u003eResults: Postictal delirium was present in 10 patients (11.11%) at 30 minutes after ECT administration. No significant differences were observed in age, number of concomitant medications, anticholinergic cognitive burden, baseline biochemical characteristics, type of anesthesia, total charge, stimulus duration, or seizure length for electroconvulsive therapy between these two groups.\u003c/p\u003e\n\u003cp\u003eConclusion: The choice of anesthetic does not predict delirium after ECT. Long seizure duration is not a risk factor for prolonged disorientation after the administration of electroconvulsive therapy. Adequate seizure duration can be administered to patients with the choice of appropriate anesthetic agents for effective ECT without risk for post-ECT delirium.\u003c/p\u003e","manuscriptTitle":"Predictors of postictal delirium at 30 minutes after electroconvulsive therapy in Indian patients","msid":"","msnumber":"","nonDraftVersions":[{"code":2,"date":"2025-04-29 14:19:03","doi":"10.21203/rs.3.rs-5375069/v2","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2024-11-18 06:28:11","doi":"10.21203/rs.3.rs-5375069/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"1345932d-b4c6-49b1-a74f-79cfb993a527","owner":[],"postedDate":"April 29th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-12-15T21:38:17+00:00","versionOfRecord":[],"versionCreatedAt":"2025-04-29 14:19:03","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v2","identity":"rs-5375069","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5375069","identity":"rs-5375069","version":["v2"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}