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Published Online:https://doi.org/10.1176/ajp.106.2.116

(1) The physiological and psychological response to intravenous epinephrine and intramuscular mecholyl of 24 neuropsychiatric patients was studied before and after a series of electric shock treatments. Special attention was given to the curves of systolic blood pressure following the injection of the drugs.

(2) Over-all effects of electric shock were:

(a) A lowering of the resting blood pressure level.

(b) An increase in the systolic blood pressure response after intravenous epinephrine.

(c) A lessened systolic blood pressure response after intramuscular mecholyl. These changes were usually accompanied by clinical improvement.

(3) Those patients who before shock treatment experienced an anxiety attack or a frank chill after injection of mecholyl showed a dramatic clinical response to electric shock treatment. Not only was their clinical condition greatly improved after a few electric shock treatments, but it was no longer possible to precipitate an anxiety attack or a chill by intramuscular mecholyl.

(4) Those patients with pretreatment high response to intravenous epinephrine (80 mm. Hg. or more) or with anxiety attacks precipitable by epinephrine showed no clinical improvement after electric shock. Anxiety was made worse.

(5) Several patients failed to show any change in pattern of response to autonomic drugs after electric shock treatment and these patients failed to show any sustained improvement in clinical condition.

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