Effect of three different dosages of magnesium sulfate on attenuating hemodynamic responses after electroconvulsive therapy: A randomized, double-blind, placebo-controlled trial

Objective: The purpose of this randomized, double-blind, placebo-controlled crossover study was to compare the efficacy of three different dosages of MgSO4 administration (10, 20, and 30 mg/kg) versus placebo on attenuation of cardiovascular response to electroconvulsive therapy (ECT). Methodology: Thirty-five adult patients scheduled for 8 ECT sessions were randomly assigned to be allocated twice into one of the four study groups: MgSO4 10 mg/kg (M10), MgSO4 20 mg/kg (M20), MgSO4 30 mg/kg (M30), and placebo control (P). Systolic (SAP), diastolic (DAP) and mean arterial pressure (MAP) and heart rate (HR) were recorded at 0, 1, 3, and 10 minutes after termination of ECT-induced seizures. Duration of electroencephalographs (EEGs) and motor seizures and peak HR during convulsions were also recorded. Results: Changes in SAP, DAP, and MAP were significantly attenuated at 0, one, and three minutes after ECT in groups M20 and M30 compared with group P (P < 0.05). Peak HR changes were significantly less in groups M20 and M30 compared with groups M10 and P (P < 0.05). Duration of motor and EEG seizure activity was not significantly different among the four groups. Conclusion: Administration of either 20 or 30 mg/kg MgSO4 significantly attenuated increased blood pressure and peak HR after ECT without decreasing seizure duration.