ECT: drugs altering seizure threshold: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · ECT: drugs altering seizure threshold

Sample item

A patient scheduled for ECT is on lorazepam and the seizure is brief and inadequate. What is the most appropriate action?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Withhold or reduce the benzodiazepine and consider flumazenil

Benzodiazepines and anticonvulsants raise the seizure threshold and shorten seizures, reducing ECT effectiveness. Dosing is reduced or timed away from sessions, and flumazenil can reverse the effect. Theophylline and caffeine can prolong seizures.

Option by option

  • A. Cancel ECT permanently

    ECT need not be cancelled permanently.

  • B. Withhold or reduce the benzodiazepine and consider flumazenil (correct)

    Correct. Reduce benzodiazepine effect to restore the seizure.

  • C. Add more lorazepam

    More lorazepam raises the threshold further.

  • D. Give a barbiturate

    Barbiturates raise the threshold.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is B, Withhold or reduce the benzodiazepine and consider flumazenil. Benzodiazepines and anticonvulsants raise the seizure threshold and shorten seizures, reducing ECT effectiveness.

Why is "Cancel ECT permanently" not the answer?

ECT need not be cancelled permanently.

Why is "Add more lorazepam" not the answer?

More lorazepam raises the threshold further.

Why is "Give a barbiturate" not the answer?

Barbiturates raise the threshold.

What concept does this question test?

It tests ECT: drugs altering seizure threshold in Psychiatry. Dosing is reduced or timed away from sessions, and flumazenil can reverse the effect. Theophylline and caffeine can prolong seizures.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study ECT: drugs altering seizure threshold?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.