title: Study of modified electroconvulsive therapy combined with risperidone oral solution in the treatment of agitation in the acute stage of epilepsy and expression level changes of insulin-like growth factor-1.
abstract: BACKGROUND
  The aim of this paper was to explore the efficacy of modified electroconvulsive therapy (MECT) combined with risperidone oral solution in the treatment of agitation in the acute stage of epilepsy, and the effects of insulin-like growth factor-1 mRNA and protein expression.
  
  
  METHODS
  Forty-six cases with seizures and agitation in the acute stage were included from February 2012 to February 2014. This study was approved by the ethics committee in our hospital. Patients were divided randomly into the experimental (23 cases) and control (23 cases) groups. The patients in the experimental group were treated with MECT combined with risperidone oral solution. The patients in the control group were treated with risperidone oral solution. The Positive and Negative Symptom Scale (PANSS) score and Treatment-Emergent Symptom Scale (TESS) score were compared before and after treatment. The insulin-like growth factor-1 (IGF-1) protein and mRNA expression level were detected with enzyme-linked immunosorbent assay (ELISA) and qRT-PCR, respectively.
  
  
  RESULTS
  There were no significant differences on positive and negative symptom scores or total score in the two groups before treatment (P>0.05). After treatment, the positive symptom score, negative symptom score, and total score all decreased in both groups, and the decrease was more obvious in the experimental group (P<0.05). After treatment, TESS scores of the experimental group were significantly lower than those of the control group (P<0.05). In the experimental group, the total efficiency was significantly higher than that in the control group (P<0.05). Before treatment, there were no significant differences in the expression levels of IGF-1 protein or mRNA in the two groups (P>0.05), while after treatment the expression levels of IGF-1 protein and mRNA decreased in both groups. However, the decrease was more obvious in the experimental group. The differences were all significant for scores (P<0.05).
  
  
  CONCLUSIONS
  The combined application of MECT and risperidone oral solution in the treatment of agitation can improve the clinical efficacy to some extent.
authors.affiliation: Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China - lichengyan2015@163.com.
authors.forename: Jiansheng
authors.initials: J
authors.lastname: Li
authors.forename: Chengyan
authors.initials: C
authors.lastname: Li
mesh_terms: D000208:Acute Disease; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D004338:Drug Combinations; D004359:Drug Therapy, Combination / Q000379:methods; D004565:Electroconvulsive Therapy / Q000379:methods; D004827:Epilepsy / Q000628:therapy*; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D036341:Intercellular Signaling Peptides and Proteins / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011595:Psychomotor Agitation / Q000628:therapy*; D018967:Risperidone / Q000008:administration & dosage / Q000627:therapeutic use*; D013002:Somatomedins / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D004338:Drug Combinations; D036341:Intercellular Signaling Peptides and Proteins; D013002:Somatomedins; C065700:myotrophin; D007334:Insulin-Like Growth Factor I; D018967:Risperidone