Acute and maintenance ECT with flupenthixol in refractory schizophrenia: sustained improvements in psychopathology, quality of life, and social outcomes.
OBJECTIVE
To determine the effects of ECT combined with antipsychotic medication therapy on psychopathology, quality of life, and social functioning in patients with refractory schizophrenia.


METHODS
An open acute (Phase I) and maintenance (Phase II) study of the combination of ECT and flupenthixol in the treatment of 46 schizophrenic patients who were nonresponsive to antipsychotic medication from at least two different classes. Scales used: the Brief Psychiatric Rating Scale (BPRS), the Quality of Life Scale (QLS), Social and Occupational Functioning Assessment Scale (SOFAS), Global Assessment of Functioning (GAF), and Mini-Mental State Exam (MMSE). The duration of Phase II was 1 year.


RESULTS
In Phase I, there were marked reductions in the BPRS scores, and substantial increases in the QLS, SOFAS, GAF, and MMSE scores. During Phase II, the BPRS negative symptoms worsened but remained improved from baseline. Changes in other outcome measures were negligible.


CONCLUSIONS
ECT and MECT combined with flupenthixol were effective in improving psychopathology in patients refractory to antipsychotic medication alone. Ratings of psychopathology, quality of life, and social functioning all improved in Phase I and were generally sustained during Phase II in patients who had remitted.
Chanpattana
Worrawat
W
Department of Psychiatry, Vajira Hospital, Srinakharinwirot University, 681 Samsen, Dusit, Bangkok 10300, Thailand. worch@loxinfo.co.th
Kramer
Barry Alan
BA
D000208:Acute Disease; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D010054:Brief Psychiatric Rating Scale; D003131:Combined Modality Therapy; D004565:Electroconvulsive Therapy; D005260:Female; D005475:Flupenthixol / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011788:Quality of Life; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D012720:Severity of Illness Index; D012917:Social Adjustment; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D005475:Flupenthixol