Benzodiazepines (BZD) possess anticonvulsant properties that may poten
tially elevate seizure threshold, inhibit seizure propagation, and alt
er some of the neurobehavioral effects of electroconvulsive shock (ECS
) in animal models. Nevertheless, considerable controversy exists rega
rding the clinical impact of oral BZD use during electroconvulsive the
rapy (ECT). The existing literature is contradictory, and all studies
attempting to address this topic suffer from important design flaws. M
ost studies are retrospective and some address only seizure duration.
Also, studies examining treatment outcome are difficult to compare bec
ause of differing types and dosages of BZD, varied electrode placement
and stimulus energy, and lack of information about the relationship o
f the stimulus energy to the patients' seizure thresholds. While firm
conclusions must await further studies, limited data suggest that BZD
have the potential to shorten seizure duration and decrease treatment
efficacy, particularly with unilateral ECT.