Effectiveness of electroconvulsive therapy in patients with treatment resistant schizophrenia: A retrospective study.
This study aimed to evaluate the effectiveness of electroconvulsive therapy (ECT) among patients with treatment resistant schizophrenia (TRS). Records of patients who had received ECT were reviewed to identify patients with TRS who were administered ECT in combination with clozapine. Socio-demographic, clinical data and ECT details were extracted. The most common diagnosis was of paranoid schizophrenia (49%) followed by undifferentiated schizophrenia (36%). A-fifth (22%) of the patients were judged to have poor response to clozapine. The mean number of ECTs given were 13.97 (SD-7.67) and mean clozapine dose was 287.5mgs/day (SD-100.1). About two-thirds (63%) of the patients showed >30% reduction in scores on different symptom-rating scales with combined use of clozapine and ECT. Among clozapine non-responders, approximately 69% responded to the combination. Post-ECT rise in blood pressure was the most common side effect (16.9%) followed by prolonged seizures (7%). Long-term follow-up data was available for 47 out of the 59 patients. More than two-third (N=34; 72%) followed-up for an average of 30 months (SD 32.3; range: 1-120), maintained well with continued clozapine treatment. To conclude, results of this study further endorse the effectiveness, safety and long-term benefits of the clozapine-ECT combination in TRS and clozapine-refractory schizophrenia.
Department of Psychiatry, Post-Graduate Institute of Medical Education and Research, Chandigarh 160012, India. Electronic address: drsandeepg2002@yahoo.com.
Sandeep
S
Grover
Department of Psychiatry, Post-Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
Subho
S
Chakrabarti
Department of Psychiatry, Post-Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
Nandita
N
Hazari
Department of Psychiatry, Post-Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
Ajit
A
Avasthi
D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D003024:Clozapine / Q000008:administration & dosage*; D003131:Combined Modality Therapy / Q000379:methods; D004565:Electroconvulsive Therapy / Q000379:methods* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome; D055815:Young Adult
D014150:Antipsychotic Agents; D003024:Clozapine
Clozapine; Clozapine non-response; Electroconvulsive therapy; Schizophrenia; Treatment-resistant