In the Journals

Isoflurane effective treatment for refractory depression

The surgical anesthetic drug isoflurane may serve as an alternative to electroconvulsive therapy for treating refractory depression, according to recent study results published in PLOS One.

“Like [electroconvulsive therapy], deep anesthesia with [isoflurane] induces a brief state of electrocortical quiescence (burst suppression on electroencephalogram), but does so without inducing convulsions or other seizure symptoms,” researchers wrote.

The pilot study included 28 participants aged 18 to 65 years with medication-refractory depression. Participants received an average of 10 treatments of bifrontal electroconvulsive therapy (ECT; n=20) or isoflurane (n=8) during a 3-week period.

Researchers found that both therapies significantly reduced symptoms of depression. However, after treatment with ECT, participants showed declines in areas of memory, verbal fluency, and processing speed immediately after treatment; most effects resolved within 4 weeks. Autobiographical memory, or recall of personal life events, remained below pretreatment levels for ECT participants 4 weeks after treatment. Participants who received isoflurane showed no real impairment and had greater improvements in cognitive testing than ECT participants immediately and 4 weeks after treatment.

Harold Weeks, MD 

Howard Weeks

“This line of research may yeild an alternative treatment option for treatment resistant depression without some of the negative side effects of current treatments,” Howard Weeks, MD, FAPA, of the University of Utah, told Psychiatric Annals. “More research is needed, however, to confirm the promising results of this pilot study. We view isoflurane as another potential tool in our toolbox for treating severe refractory depression.”

Disclosure: The study was funded in part by the Departments of Anesthesiology and Psychiatry at the University of Utah.

The surgical anesthetic drug isoflurane may serve as an alternative to electroconvulsive therapy for treating refractory depression, according to recent study results published in PLOS One.

“Like [electroconvulsive therapy], deep anesthesia with [isoflurane] induces a brief state of electrocortical quiescence (burst suppression on electroencephalogram), but does so without inducing convulsions or other seizure symptoms,” researchers wrote.

The pilot study included 28 participants aged 18 to 65 years with medication-refractory depression. Participants received an average of 10 treatments of bifrontal electroconvulsive therapy (ECT; n=20) or isoflurane (n=8) during a 3-week period.

Researchers found that both therapies significantly reduced symptoms of depression. However, after treatment with ECT, participants showed declines in areas of memory, verbal fluency, and processing speed immediately after treatment; most effects resolved within 4 weeks. Autobiographical memory, or recall of personal life events, remained below pretreatment levels for ECT participants 4 weeks after treatment. Participants who received isoflurane showed no real impairment and had greater improvements in cognitive testing than ECT participants immediately and 4 weeks after treatment.

Harold Weeks, MD 

Howard Weeks

“This line of research may yeild an alternative treatment option for treatment resistant depression without some of the negative side effects of current treatments,” Howard Weeks, MD, FAPA, of the University of Utah, told Psychiatric Annals. “More research is needed, however, to confirm the promising results of this pilot study. We view isoflurane as another potential tool in our toolbox for treating severe refractory depression.”

Disclosure: The study was funded in part by the Departments of Anesthesiology and Psychiatry at the University of Utah.