Low-dose atropine in electroconvulsive therapy

Anticholinergic medications such as atropine or glycopyrrolate have long be en used in electroconvulsive therapy (ECT) to eliminate parasympathetically mediated dysrhythmias. However, such agents increase heart rate and myocar dial workload and may increase risk of cardiac adverse events. What is need ed is an intervention that is parasympatholytic without substantially incre asing myocardial workload. In this study, a low dose of atropine was compar ed with placebo in ECT with attention to heart rate, blood pressure, cardia c rhythm, myocardial workload, and parasympathetic function. The dose of at ropine that was used effectively blocked vagal tone with only a small and p robably not clinically significant rise in myocardial workload for only a f ew minutes after the ECT seizure.