Study of Flumazenil to Reverse Benzodiazepine Effects During Electroconvulsive Therapy for Adults With Depression

What this Trial Is About

Researchers are evaluating whether giving flumazenil to reverse the effects of benzodiazepines andor zopiclone during electroconvulsive therapy ECT can reduce cognitive side effects without lowering treatment effectiveness in hospitalized adults with depression. This study focuses on adults diagnosed with major depressive disorder or bipolar disorder currently experiencing a depressive episode and eligible for ECT. The goal is to see if blocking the GABA receptor with flumazenil improves seizures and reduces the need to increase electrical charge during the ECT series, potentially lessening cognitive impacts. Participants are randomly assigned to one of two groups the experimental group continues benzodiazepine andor zopiclone treatment up to the ECT session and then receives flumazenil just before anesthesia to reverse the drugs effects the comparison group follows usual care by stopping benzodiazepines andor zopiclone the day before each ECT session. ECT is given according to standard clinical practices, with assessments conducted throughout the treatment series and after completion. Participants undergo baseline cognitive and mood assessments before the first or second ECT session, including tests of memory, executive function, and subjective cognitive complaints. During each ECT session, anxiety levels, seizure quality, and recovery times are recorded. Follow-up assessments occur 3 to 7 days after finishing ECT, repeating cognitive tests, depression ratings, and treatment satisfaction surveys. Brain imaging with MRI is also performed at follow-up to examine structural and functional changes related to memory and executive function. The primary outcome is cognitive function measured by the Screening for Cognitive Impairment in Psychiatry SCIP.

Flumazenil for Benzodiazepine Reversal in Electroconvulsive Therapy