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The handle http://hdl.handle.net/1887/37228 holds various files of this Leiden University dissertation

Author: Mirzakhani, Hooman

Title: The role of clinical pharmacology and pharmacogenetics in electroconvulsive therapy : from safety to efficacy

Issue Date: 2016-01-14

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THE ROLE OF CLINICAL PHARMACOLOGY AND PHARMACOGENETICS IN ELECTROCONVULSIVE THERAPY

FROM SAFETY TO EFFICACY

Hooman Mirzakhani, M.D., MMSc.

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The research presented in this thesis was performed at the Departments of Clinical Pharmacy and Toxicology of Leiden University Medical Center, Leiden, The Netherlands and Anesthesia, Critical Care and Pain Medicine of Massachusetts General Hospital, Boston, Massachusetts, United States.

Financial support for the publication of this thesis was provided by AZL Onderzoeks- en Ontwikkelings- krediet Apotheek.

Cover design Midas Mentink, Midas.Mentink.nl Layout Mentink, Midas.Mentink.nl Printed by Gildeprint, Enschede ISBN/EVA 978-94-92026-08-8

© 2016 Hooman Mirzakhani

All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage or retrie- val system, without permission in writing from the author.

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THE ROLE OF CLINICAL PHARMACOLOGY AND PHARMACOGENETICS IN ELECTROCONVULSIVE THERAPY

FROM SAFETY TO EFFICACY

Proefschrift

ter verkrijging van

de graad van Doctor aan de Universiteit Leiden, op gezag van Rector Magnificus prof.mr. C.J.J.M. Stolker,

volgens besluit van het College voor Promoties te verdedigen op donderdag 14 januari 2016

klokke 16:15 uur door

Hooman Mirzakhani, M.D., MMSc.

geboren te Tehran

in 1970

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Promotores Prof. dr. H.J. Guchelaar

Prof. dr. A. Dahan

Copromotor Dr. J.J. Swen

Leden promotiecommissie Prof. dr. A.C.G. Egberts, Universiteit Utrecht

Prof. dr. L.P.H.J. Aarts

Dr. H.G. Ruhé, Universiteit Groningen Dr. I.M. van Vliet

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CONTENTS

Chapter 1 General Introduction

Chapter 2 Neuromuscular blocking agents for electroconvulsive therapy: A systematic review.

Chapter 3 Optimal Doses of Succinylcholine and Rocuronium during Electroconvulsive Therapy:

A prospective, randomized, crossover trial Chapter 4 Pharmacokinetics and Pharmacodynamics of

Succinylcholine and Rocuronium during Electroconvulsive Therapy.

Chapter 5 Pharmacogenetics in Electroconvulsive Therapy and

Adjunctive Medications.

Chapter 6 CYP2D6 metabolizer phenotypes in patients undergoing ECT after antidepressant therapy.

Chapter 7 Profound hypotension after anesthetic induction with propofol in patients treated with rifampin.

Chapter 8 Severe postoperative hemodynamic events after spinal anesthesia : a prospective observational study.

Chapter 9 General discussion and future directions Appendices Summary

Samenvatting Dankwoord

About the author List of publications

11 17

41

63

83

113

129

141

155 174 178 181 182 183

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“It’s not that I’m so smart, it’s just that I stay with problems longer.”

Albert Einstein

(1879-1955)

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