Electroconvulsive therapy for schizophrenia

Tharyan, Prathap; Adams, Clive E

doi:10.1002/14651858.cd000076.pub2

Cited by 219 publications

(168 citation statements)

References 142 publications

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“…Most studies of ECT did not conduct a comparison to monotherapy with atypical agents as an alternative. ECT should be considered in patients suffering from severe affective symptoms, as there is limited evidence in trials and clinical knowledge to confirming its efficacy in such cases (APA 2004;Tharyan and Adams 2004) (Level C ).…”

Section: Electroconvulsive Therapy (Ect)mentioning

confidence: 99%

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia, Part 2: Long-term treatment of schizophrenia

Falkai

Wobrock

Lieberman

et al. 2006

The World Journal of Biological Psychiatry

201

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These guidelines for the biological treatment of schizophrenia were developed by an international Task Force of the World Federation of Societies of Biological Psychiatry (WFSBP). The goal during the development of these guidelines was to review systematically all available evidence pertaining to the treatment of schizophrenia, and to reach a consensus on a series of practice recommendations that are clinically and scientifically meaningful based on the available evidence. These guidelines are intended for use by all physicians seeing and treating people with schizophrenia. The data used for developing these guidelines have been extracted primarily from various national treatment guidelines and panels for schizophrenia, as well as from meta-analyses, reviews and randomised clinical trials on the efficacy of pharmacological and other biological treatment interventions identified by a search of the MEDLINE database and Cochrane Library. The identified literature was evaluated with respect to the strength of evidence for its efficacy and then categorised into four levels of evidence (A Á/D). This second part of the guidelines covers the long-term treatment as well as the management of relevant side effects. These guidelines are primarily concerned with the biological treatment (including antipsychotic medication, other pharmacological treatment options, electroconvulsive therapy, adjunctive and novel therapeutic strategies) of adults suffering from schizophrenia.Key words: Schizophrenia, long-term treatment, evidence-based medicine, practice guidelines, biological treatment, antipsychotics EXECUTIVE SUMMARY OF RECOMMENDATIONS General recommendationsSpecific treatment strategies are required not only for patients suffering from acute schizophrenia, but also in the stabilisation and stable phase of the disease. The stabilisation period follows the acute phase and constitutes a time-limited transition to continuing treatment in the stable phase. The stable phase represents a prolonged period of treatment and rehabilitation during which symptoms are under adequate control and the focus is on improving functioning and recovery. The goals of long-term therapy have to be discussed with the patient on the background of adequately provided information and his personal goals in order to find common ground to encourage a long-term medication strategy (shared-decision making). In this regard a treatment plan must be formulated and implemented. During the stabilisation phase, the main goals of treatment are to facilitate continued reduction in symptoms, consolidate remission, and promote the process of recovery. The main goals of treatment during the stable phase are to ensure that symptom remission or control is sustained, that the patient is maintaining or improving the level of functioning and quality of life, to prevent relapse, and to ensure that monitoring for adverse treatment effects continues. The antipsychotic pharmacological therapy should be accompanied by psychosocial interventions. A number of psychosocial...

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Section: Electroconvulsive Therapy (Ect)mentioning

confidence: 99%

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia, Part 2: Long-term treatment of schizophrenia

Falkai

Wobrock

Lieberman

et al. 2006

The World Journal of Biological Psychiatry

201

View full text Add to dashboard Cite

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“…Nevertheless, the clinical efficacy of ECT in OCD is still unproven. Published data-mostly case-report series-have shown mixed results (Table 1) [29][30][31][32][33][34] and it may be that ECT reduces OCD by treating mental conditions comorbid with OCD (ie, schizophrenia, 35 depression, 36 Tourette's syndrome 37 ) rather than directly reducing OCD. A recent evolution of ECT is MST, a form of convulsive therapy in which a magnetic stimulus 38,39 replaces the electrical stimulus used in ECT.…”

Section: Electroconvulsive Therapy and Magnetic Seizure Therapymentioning

confidence: 99%

Brain Stimulation Techniques in the Treatment of Obsessive-Compulsive Disorder: Current and Future Directions

et al. 2005

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Recent studies on the epidemiology of obsessive-compulsive disorder (OCD) estimate 50 million patients suffer from OCD worldwide, thus making it a global problem. The treatment of OCD has changed substantially over the last 2 decades following the introduction of selective serotonin reuptake inhibitors, which provide symptom improvement in ~60% of patients. However, some patients remain resistant to the standard pharmacologic and behavioral treatments. Although some Needs AssessmentIn the last decade, brain stimulation approaches to neuropsychiatric disorders have been increasingly investigated and are currently defining a "third way" of treatment besides the traditional ones, pharmacologic therapy and psychotherapy. Although some of these techniques are well-established treatments for specific conditions (ie, electroconvulsive therapy for severe depression or deep brain stimulation and transcranial magnetic stimulation in motor disorders) their efficacy in severe or treatment-resistant obsessive-compulsive disorder is still under investigation. Nevertheless, they represent a potential, helpful approach in this highly debilitating condition not only amongst the therapeutic approaches to obsessive-compulsive disorder but also as research means able to elucidate the specific dysfunctional neurocircuits underlying the clinical symptomatology. Learning ObjectivesAt the end of this activity, the participant should be able to:• Differentiate the specific techniques of brain stimulation investigated in the treatment of obsessive-compulsive disorder (OCD) in terms of efficacy, invasiveness, tolerability, and side effects.• Understand the main hypotheses through which these techniques might modify the dysfunctional circuits of OCD.• Understand the potential of these techniques in the field of treatment-resistant OCD, on one hand, and their current investigational state that requires further controlled clinical trials, on the other hand. Target Audience Neurologists and psychiatrists Accreditation StatementMount Sinai School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide Continuing Medical Education for physicians.Mount Sinai School of Medicine designates this educational activity for a maximum of 3.0 Category 1 credit(s) toward the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the educational activity.It is the policy of Mount Sinai School of Medicine to ensure fair balance, independence, objectivity and scientific rigor in all its sponsored activities. All faculty participating in sponsored activities are expected to disclose to the audience any real or apparent discussion of unlabeled or investigational use of any commercial product or device not yet approved in the United States.This activity has been peer-reviewed and approved by Eric Hollander, MD, professor of psychiatry, Mount Sinai School of Medicine. Review Date: November 1, 2005. To Receive Credit for This ActivityRead this article, and...

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“…Until now, paradoxical and different studies have been conducted on animal and human samples upon factors capable of reducing cognitive side effects and memory deficit followed by ECT (8,(26)(27)(28)(29)(30). However, these studies were limited in the level of human samples.…”

Section: Mind Controlmentioning

confidence: 99%

The Effect of Naltrexone on Memory Deficit Followed by Electroconvulsive Therapy: A Randomized, Double-Blind, Placebo-Controlled Trial

Motazedian

Noorbakhsh

Shams

et al. 2017

Iran Red Crescent Med J

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Background: Electroconvulsive therapy (ECT) is famously known as a treatment for depression; however, memory impairments have always been a point of concern. The use of opioid antagonists may protect against the development of memory deficits after ECT. The current study aimed at assessing the effect of Naltrexone in diminishing memory impairments. Methods: This randomized, double-blinded, placebo-controlled clinical trial took place at Imam Hossein hospital of Tehran/Iran. Patients diagnosed with MDD, were assigned to either Naltrexone or placebo and received 6 sessions of ECT within 2 weeks. Wechsler Memory Scale was performed the day before the first session of ECT, as well as 2 weeks, 1 and 3 months after finishing the 6th session. The Hamilton depression rating scale was performed 2 times to examine the possible interference caused by depression or to relapse as a confounding variable. Results: Patients receiving Naltrexone and placebo showed no significant difference in WMS scores. However, after further assessment, changes of WMS scores in every round were compared; the results showed that after 2 weeks from baseline, the amount of the reduction of total WMS scores from baseline was significantly lower in the Naltrexone group (P = 0.04). Conclusions: This study suggests that Naltrexone as compared to placebo has no advantageous effect on attenuating memory deficits in the long term. It is a smaller degree of memory decline that makes Naltrexone superior to placebo.

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Electroconvulsive therapy for schizophrenia

Cited by 219 publications

References 142 publications

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia, Part 2: Long-term treatment of schizophrenia

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia, Part 2: Long-term treatment of schizophrenia

Brain Stimulation Techniques in the Treatment of Obsessive-Compulsive Disorder: Current and Future Directions

The Effect of Naltrexone on Memory Deficit Followed by Electroconvulsive Therapy: A Randomized, Double-Blind, Placebo-Controlled Trial

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