Arterial hypertension and multiple cerebral aneurysms in a patient treated with electroconvulsive therapy.

The authors successfully instituted two courses of ECT at a 1-year interval for drug-resistant major depression in a patient with arterial hypertension and intracranial aneurysms. Both ECT courses required arterial and central venous cannulas, but the first course was complicated by an unusual and excessive degree of hypertension, which was not appropriately responsive to high doses of sodium nitroprusside (9 micrograms/kg/minute). Appropriate responsiveness to nitroprusside was established after therapy with timolol. The combination of sodium nitroprusside and timolol proved effective throughout the second course of ECT.