بررسی مقایسه ای اختلالات شناختی و برخی خصوصیات تشنجی شوک درمانی در بیماران مانیک با و بدون ترکیب همزمان با والپروات سدیم

Introduction & Objective: Both sodium valproate and electroconvulsive therapy (ECT) are ef-fective treatments for mania, but there is no clinical trial evidence for safety when they are used together. The aim of this study was the comparison of cognitive impairment and seizure parameters in manic patients receiving electroconvulsive therapy with or without concurrent treatment with sodium valproate. Materials & Methods: In this clinical trial study we recruited forty hospitalized manic patients who were to receive ECT for at least six sessions and randomly assigned them to either group C, who continued to take sodium valproate during the study, or group D, who discontinued it. Through the course of ECT sessions, Mini Mental Status Examination (MMSE), applied stimulus intensity (seizure threshold), and motor seizure duration were repeatedly measured . The data was analyzed using t & Χ2 statistically tests. Results: Baseline MMSE scores were nearly equal in the two groups. By the end of the sixth session, the scores decreased by 1.15 in group C and increased by 0.65 in group D (mean difference between the groups =1.8 ,P=0.028). A rising trend in the applied stimulus intensity was observed in both groups. Seizure thresholds were lower in group C in most of the sessions, but after adjustment for sex, these differences were no longer significant. Seizures of the sixth session were 3.95 seconds shorter than of the first one in group C (P=0.045). This shortening did not occur in group D. There were 15.8% more inadequate seizures (i.e. dura-tion less than 25 seconds) in group C than in group D (P=0.006). The two groups did not dif-fer in the number of applied ECT sessions. Conclusion: Continuing sodium valproate during ECT results in poorer cognitive performance and more inadequate seizures.