Combining ECT and antipsychotic agents: benefits and risks

A comprehensive review describes the benefits and risks of the combination of electroconvulsive therapy (ECT) and antipsychotic agents for patients with psychotic disorders. For some patients, combined treatment may lead to greater rates of response or more rapid improvement than with either therapy alone. Except for reserpine, combining neuroleptics with ECT is safe, but some precautions are suggested. The mechanism of interaction, effect on seizure threshold, the use of ECT for neuroleptic associated motor effects, and additional anesthesia considerations are discussed.