Comparative Study of Clozapine, Electroshock and the Combination of ECT with Clozapine in Treatment-Resistant Schizophrenic Patients

Masoudzadeh, Abbas; Khalilian, A R

doi:10.3923/pjbs.2007.4287.4290

Cited by 67 publications

(26 citation statements)

References 10 publications

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“…Data from retrospective studies and open trials suggest a potential benefit of ECT augmentation for patients who have failed clozapine [26]; however, no controlled RCTs had been conducted until recently. Petrides et al [22] published a prospective, randomized study highlighting the synergistic effects of ECT plus clozapine.…”

Section: Resultsmentioning

confidence: 99%

Electroconvulsive Therapy and Schizophrenia: A Systematic Review

Ali¹,

Mathur²,

Malhotra³

et al. 2019

Complex Psychiatry

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Electroconvulsive therapy (ECT) is a remarkably effective treatment for major depressive disorder, but is less commonly utilized for treatment of psychotic disorders. Recent literature indicates that ECT can be a useful strategy for a wide range of psychotic disorders, including treatment-resistant schizophrenia. The purpose of this review is to examine the extant literature on ECT in schizophrenia with a primary focus on its efficacy, its impact on cognitive function, the role of maintenance ECT, and the potential role of neuroimaging biomarkers to provide more precise ECT treatment strategies. We evaluated the available literature, with a particular focus on prospective, randomized trials. Our review suggests that ECT can be an effective treatment strategy in this severely ill patient population. Studies suggest that while ECT in schizophrenia is a safe treatment modality, the potential for cognitive impairment must always be carefully weighed. The use and investigation of new biomarker strategies for the pharmacological treatment of schizophrenia, and the extension of these approaches to ECT are also discussed.

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Section: Resultsmentioning

confidence: 99%

Electroconvulsive Therapy and Schizophrenia: A Systematic Review

Ali¹,

Mathur²,

Malhotra³

et al. 2019

Complex Psychiatry

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show abstract

“…From the 35 included publications investigating the effect of ECT on schizophrenia, 16 were prospective interventional studies (Chanpattana & Chakrabhand, 2001a;Chanpattana & Kramer, 2003;Chanpattana & Sackeim, 2010;Ipekcioglu et al, 2018;Jia et al, 2019;Kho et al, 2004;Li et al, 2016;Masoudzadeh et al, 2007;Pawełczyk et al, 2014aPawełczyk et al, , 2014bPetrides et al, 2015;Tang & Ungvari, 2001Zhang et al, 2012), two naturalistic observation studies (Kim et al, 2018;Usta Saglam et al, (Bansod et al, 2018), one retrospective controlled study (Jia et al, 2019) and one retrospective chart review (Xiang et al, 2015). Six literature reviews (Chanpattana, 2007;Chanpattana & Andrade, 2006;Dokucu, 2015;Hasan et al, 2015b;Lehnhardt et al, 2012;Remington et al, 2016), two systematic reviews (Sinclair et al, 2019;Tharyan & Adams, 2005) and two meta-analyses (Ahmed et al, 2017;Zheng et al, 2016), giving an overview of some aspects of the effect of ECT on schizophrenia, were also included in this review.…”

Section: Study Characteristics and Designmentioning

confidence: 99%

“…In two of the studies, the assessors were blinded (Davarinejad et al, 2019;Petrides et al, 2015) and only one study was double-blinded with sham treatment (Masoudzadeh et al, 2007). Of the prospective interventional studies, 15 were considered openlabel studies as they did not mention blinding (Bansod et al, 2018;Chanpattana & Chakrabhand, 2001a;Chanpattana & Kramer, 2003;Chanpattana & Sackeim, 2010;Ipekcioglu et al, 2018;Kho et al, 2004;Kim et al, 2018;Li et al, 2016;Pawełczyk et al, 2014aPawełczyk et al, , 2014bTang & Ungvari, 2001Zhang et al, 2012).…”

Section: Study Characteristics and Designmentioning

confidence: 99%

“…Full-text papers screened for eligibility (n=35) Included (n=35): prospective interventional studies (n=16); case reports (n=4); naturalistic observation studies (n=2); naturalistic comparison studies (n=1); literature reviews (n=6); systematic review (n=2); meta-analyses (n=2); retrospective controlled studies (n=1); retrospective chart reviews (n=1) Excluded (n=18): not written in English or German (2), does not focus on negative symptoms (n=9), on ECT (n=6) or on schizophrenia (n=1) Fig. 1 Flowchart of the review identification and selection process Masoudzadeh et al, 2007;Pawełczyk et al, 2014aPawełczyk et al, , 2014bPetrides et al, 2015;Tang & Ungvari, 2001Zhang et al, 2012). In two other studies, ECT was administered twice weekly (Kho et al, 2004;Usta Saglam et al, 2020), in one study every other day up to ten ECTs (Li et al, 2016) and in one study according to a protocol with increasing time periods between the ECTs (Bansod et al, 2018).…”

Section: Treatment Plansmentioning

confidence: 99%

“…In 14 of the 21 studies, the ECT protocols specified bilateral electrode placement (Chanpattana & Chakrabhand, 2001a;Chanpattana & Kramer, 2003;Chanpattana & Sackeim, 2010;Ipekcioglu et al, 2018;Kim et al, 2018;Li et al, 2016;Pawełczyk et al, 2014aPawełczyk et al, , 2014bPetrides et al, 2015;Tang & Ungvari, 2001Usta Saglam et al, 2020;Zhang et al, 2012), while four specified unilateral use of the electrodes (Davarinejad et al, 2019;Jia et al, 2019;Kho et al, 2004;Masoudzadeh et al, 2007). The focus of Bansod et al (2018) was to compare three groups with different electrode placement options (i.e.…”

Section: Treatment Plansmentioning

confidence: 99%

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Electroconvulsive therapy for negative symptoms in schizophrenia: a literature review from 2000 to 2021

et al. 2021

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Negative symptoms in schizophrenia remain a clinical challenge with small effect sizes and evidence for pharmacological or psychotherapeutic treatment approaches. Studies suggest that electroconvulsive therapy (ECT) holds some promise as a treatment option of often persistent negative symptoms with clinically meaningful effects. This review summarizes the existing evidence on the efficacy of ECT on negative symptoms in patients with schizophrenia. Thirty-five publications were included in this literature review comprising 21 studies, two meta-analyses, eight reviews and four case reports. Conclusions should be interpreted cautiously, given the small number and methodological shortcomings of the included publications with a variation of study designs and missing standardized protocols. Implications for future research and practice are critically discussed. Recommendations are given to provide more evidence that will meet the clinical challenge of reducing the negative symptoms in schizophrenia. Study designs that focus explicitly on negative symptoms and assess patients over longer follow up periods could be helpful. Future research should include control groups, and possibly establish international multicentered studies to get a sufficient study population. Findings suggest that patients with schizophrenia resistant to pharmacological treatment might benefit from ECT. A risk and benefit assessment speaks in favour of the ECT treatment. Future practice of ECT should include a combination treatment with antipsychotics. Whereas the use of anaesthetics and electrode placement does not seem to play a role, the recommendation regarding frequency of ECT treatments is currently three times a week, For the assessment of negative symptoms the assessment tool should be chosen carefully.

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Schizophrenia and Related Psychoses

2021

The Maudsley Prescribing Guidelines in Psychiatry

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Despite disagreements about nomenclature, patients who develop schizophrenic or schizophrenialike symptoms in later life are often seen in clinical practice. Questions about the etiology of late-life psychotic disorders and about their similarities or differences from early-onset disorders remain unanswered. Neuroimaging techniques have been used to study patients with late onset of psychosis, and in substantial subgroups of patients (from 25% to 100% in various studies) compared with agematched control subjects, structural and functional abnormalities have been found. We review the literature on imaging in late-life schizophrenia and related psychotic disorders, and we present data from our own investigations of patients with these disorders. We discuss the potential usefulness of imaging evaluations in patients with late-onset disorders, and we offer suggestions for future investigations.

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Comparative Study of Clozapine, Electroshock and the Combination of ECT with Clozapine in Treatment-Resistant Schizophrenic Patients

Cited by 67 publications

References 10 publications

Electroconvulsive Therapy and Schizophrenia: A Systematic Review

Electroconvulsive Therapy and Schizophrenia: A Systematic Review

Electroconvulsive therapy for negative symptoms in schizophrenia: a literature review from 2000 to 2021

Schizophrenia and Related Psychoses

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