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The following is a summary of “Allopregnanolone and progesterone in relation to a single electroconvulsive therapy seizure and subsequent clinical outcome: an observational cohort study,” published in the October 2024 issue of Psychiatry by Thörnblom et al. 

Electroconvulsive therapy (ECT) is a critical treatment for severe psychiatric conditions, but its mechanisms remain unclear; specifically, the relationship between serum allopregnanolone and progesterone levels following ECT seizures has not been fully explored. 

Researchers conducted a prospective study to measure serum allopregnanolone and progesterone levels after a single ECT seizure and evaluate their relationship with clinical outcomes. 

They included 130 participants (18–85 years) and assessed generalization parameters such as peak ictal heart rate, electroencephalographic (EEG) seizure duration, and prolactin increase. Outcome measures included clinical global improvement, perceived health status, and subjective memory impairment, analyzed using non-parametric tests and regression analyses. 

The results showed that allopregnanolone and progesterone remained unchanged, with no correlation to seizure generalization or clinical outcomes. Progesterone increased in men (n = 50), and allopregnanolone changes negatively correlated with EEG seizure duration. In a subgroup analysis (n = 62), higher baseline allopregnanolone and progesterone correlated with postictal EEG suppression. 

The study concluded that ECT seizures produce distinct physiological effects compared to generalized seizures in epilepsy, and that progesterone may influence psychiatric conditions in men. 

Source: bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-06167-3#Abs1