Effects of Repeated Electroconvulsive Therapy Sessions on Anesthetic Requirements (REPEAT-ECT)

February 11, 2026 updated by: Murat Kaykaç, Izmir City Hospital

Effects of Repeated Electroconvulsive Therapy on Anesthetic Requirements: A Prospective Observational Study

Electroconvulsive therapy (ECT) is an effective treatment for severe depression and other psychiatric disorders. ECT is usually given in several sessions on different days. During each session, patients receive short-acting anesthesia to ensure comfort and safety.

This study aims to evaluate whether the amount of anesthetic medication required changes during repeated ECT sessions in the same patient. In addition, the study will examine the relationship between anesthetic dose, seizure duration, seizure quality (measured by postictal suppression index), and recovery time.

This is a prospective observational study. All anesthesia and ECT procedures will be performed according to routine clinical practice. No additional intervention will be applied for research purposes.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Electroconvulsive therapy (ECT) is a well-established biological treatment for treatment-resistant depression and other affective disorders. Adequate anesthesia is essential to ensure patient safety while maintaining optimal seizure quality and therapeutic efficacy. Short-acting anesthetic agents are commonly used in ECT due to their favorable recovery profiles and hemodynamic stability.

Previous studies suggest that anesthetic requirements may change across repeated ECT sessions, potentially influencing seizure duration, seizure quality, and recovery time. However, evidence regarding within-patient changes in anesthetic dose requirements and their relationship with electroencephalographic seizure characteristics remains limited.

This prospective observational cohort study aims to evaluate changes in anesthetic requirements during repeated ECT sessions in adult patients. Secondary objectives include examining the association between anesthetic dose, seizure duration (motor and EEG), postictal suppression index (PSI), and recovery time.

All ECT and anesthesia procedures will be conducted according to institutional routine clinical protocols. The research team will not interfere with clinical decision-making. Data will be collected from anesthesia records and EEG documentation. Mixed-effects statistical models will be used to account for repeated within-subject measurements.

Study Type

Observational

Enrollment (Estimated)

35

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Murat KAYKAC, Specialist, MD
  • Phone Number: +905330258450
  • Email: mrtkykc@gmail.com

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Adult patients aged 18-65 years with an established indication for electroconvulsive therapy (ECT) who are scheduled to undergo multiple ECT sessions at a tertiary care hospital. Participants will be consecutively enrolled during the study period according to eligibility criteria. All procedures will be performed as part of routine clinical care.

Description

Inclusion Criteria:

Age 18 to 65 years.

Scheduled to undergo electroconvulsive therapy (ECT) under elective conditions as part of routine clinical care.

ECT indication (e.g., major depressive disorder, bipolar depression, schizoaffective disorder, catatonia).

ASA Physical Status I-III.

Planned to receive multiple ECT sessions.

Able to provide written informed consent (participant and/or legally authorized representative).

Exclusion Criteria:

Use of antiepileptic drugs or benzodiazepines that may affect seizure threshold.

ECT received within the past 6 months.

Severe cardiovascular, pulmonary, or neurologic comorbidity (investigator judgment).

Pregnancy or breastfeeding.

ASA Physical Status IV or higher.

Acute substance or alcohol use disorder/intoxication.

Conditions preventing EEG monitoring (e.g., scalp trauma, significant skin lesions, cranial implants).

Inability to obtain reliable BIS monitoring during anesthesia induction due to technical limitations.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Adults Undergoing Repeated ECT
Adult patients aged 18-65 years with an indication for electroconvulsive therapy (ECT) who are scheduled to undergo multiple ECT sessions under routine clinical practice. All anesthesia and ECT procedures will be performed according to standard institutional protocols. No additional intervention will be applied for research purposes. Repeated within-subject measurements will be collected across ECT sessions.
Procedure: Electroconvulsive Therapy (ECT)
Electroconvulsive therapy administered as part of routine clinical care. The study does not assign or modify the intervention. Anesthetic management and ECT parameters are determined by treating physicians according to standard institutional protocols.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Anesthetic Dose Requirement Across Repeated ECT Sessions
Time Frame: Across the first 4 ECT sessions per participant (from Session 1 to Session 4), during the study period (up to 3 months).
Dose (mg) of the anesthetic agent administered for each ECT session (e.g., propofol or etomidate), recorded from anesthesia records and analyzed as within-subject change across sequential sessions.
Across the first 4 ECT sessions per participant (from Session 1 to Session 4), during the study period (up to 3 months).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Izmir City Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

March 15, 2026

Primary Completion (Estimated)

June 15, 2026

Study Completion (Estimated)

June 15, 2026

Study Registration Dates

First Submitted

February 11, 2026

First Submitted That Met QC Criteria

February 11, 2026

First Posted (Actual)

February 18, 2026

Study Record Updates

Last Update Posted (Actual)

February 18, 2026

Last Update Submitted That Met QC Criteria

February 11, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2025/586

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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