Use of Gabapentin during ECT for Myalgia and Anxiety: Effects on Seizure Activity

Aim: The goal was to determine if use of gabapentin could assist with management of myalgia and anxiety in a patient treated with Electroconvulsive therapy (ECT) for depression, without interfering with seizure activity during ECT.
Methods: A patient was scheduled for ECT but was reluctant to continue after completing the first session, due to myalgia and anxiety. Medical history and clinical data were noted. He had comorbid alcohol use disorder, so benzodiazepines were avoided. His response to ECT was followed while taking gabapentin for myalgia, anxiety and alcohol cravings.
Results: Gabapentin did not interfere with seizure intensity and did not reduce seizure duration. The patient experienced complete relief of myalgia within 24 hours and reduced anxiety and alcohol cravings while taking gabapentin. He experienced relief of depression through a course of seven ECT sessions.
Conclusion: Gabapentin appears to be a promising adjunct during ECT to manage anxiety and myalgia as it did not interfere with seizure duration or clinical effect on depression. Although randomized, controlled trials must be performed; this case supports its use during ECT for these symptoms.