Short Courses of E.C.T. and Simulated E.C.T. in Chronic Schizophrenia

Heath, E. S.; Adams, Anne; Wakeling, P. L. G.

doi:10.1192/bjp.110.469.800

Cited by 19 publications

(14 citation statements)

References 8 publications

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“…In a study published in 1959, Brill et al39 treated 67 male patients with chronic schizophrenia with ECT or pentothal alone. In a third study published in 1964, Heath et al40 compared ECT to sham ECT involving pentothal anesthesia alone in 45 patients with chronic schizophrenia. None of these studies found any appreciable differences between treatment groups in clinical outcome.…”

Section: Overview Of Efficacy Researchmentioning

confidence: 99%

Electroconvulsive Therapy: Part I. A Perspective on the Evolution and Current Practice of ECT

Payne

Prudic²

2009

Journal of Psychiatric Practice

147

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The concept of inducing convulsions, mainly through chemical means, to promote mental wellness has existed since the 16th century. In 1938, Italian scientists first applied electrically induced therapeutic seizures. Although electroconvulsive therapy (ECT) is employed in the treatment of several psychiatric disorders, it is most frequently used today to treat severe depressive episodes and remains the most effective treatment available for those disorders. Despite this, ECT continues to be the most stigmatized treatment available in psychiatry, resulting in restrictions on and reduced accessibility to a helpful and potentially life-saving treatment. The psychiatric and psychosocial ramifications of this stigmatization may include the exacerbation of the increasingly serious, global health problem of major depressive disorders as well as serious consequences for individual patients who may not be offered, or may refuse, a potentially beneficial treatment. The goal of this first article in this two-part series is to provide an overview of ECT's historical development and discuss the current state of knowledge about ECT, including technical aspects of delivery, patient selection, its side-effect profile, and factors that may contribute to underuse of ECT.

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Section: Overview Of Efficacy Researchmentioning

confidence: 99%

Electroconvulsive Therapy: Part I. A Perspective on the Evolution and Current Practice of ECT

Payne

Prudic²

2009

Journal of Psychiatric Practice

147

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“…Another aspect of the literature has been real versus sham ECT studies. In general terms, pre 1980 studies failed to show an advantage for ECT 4–6 whereas later studies show substantial advantage in short‐term therapeutic outcome 7–9 . Factors likely to account for this include the chronicity of patients studied (unremitting chronic patients in the older studies, compared to the greater inclusion of patients with acute exacerbations in the newer studies) and the use of concomitant antipsychotic medication (in the newer studies, both in the sham and the ECT groups) 3…”

Section: Efficacy: What Does the Literature Say?mentioning

confidence: 99%

The Role of ECT in Schizophrenia

Keuneman

Weerasundera

Castle

2002

Australas Psychiatry

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Objective:To review the place of electroconvulsive therapy (ECT) in the treatment of schizophrenia. Conclusions:ECT is as effective, if not more so, than the antipsychotic drugs in certain clinical settings. It can be rapidly effective in acute episodes. When used alone, antipsychotics have comparable or superior efficacy to ECT alone in the short term. However, ECT possibly confers better long-term outcome. Combination treatment with antipsychotic medications and ECT is superior to either treatment alone, and is safe and effective, notably in medication resistant schizophrenia. Benefits of acute courses of ECT may be short-lived unless maintenance ECT is instituted, although there are limited data on the subject. Clinically, patients with acute onset, shorter episodes are more likely to respond to ECT. Catatonia, preoccupation with delusions and hallucinations, and a relative absence of premorbid schizoid and paranoid personality traits, are other clinical factors less strongly predictive of positive response. The presence of affective symptoms is often thought to be predictive of clinical response. However, there is little research evidence for this. While medications remain the mainstay of treatment in schizophrenia, ECT does have a clear and increasingly recognised role which requires further evaluation.

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“…Among the early studies, only one found a therapeutic advantage for ECT [49], the others did not [43,[50][51][52][53]. Three sham ECT-controlled studies in the 1980s suggested short-lived clinical benefits [54][55][56], but these studies were also methodological flawed.…”

Section: Previous Studies On the Efficacy Of Ectmentioning

confidence: 93%

Electroconvulsive Therapy for Schizophrenia

Chanpattana¹

2007

CPSR

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The role of electroconvulsive therapy (ECT) in treating patients with schizophrenia remains unclear. This paper aims to determine whether ECT results in clinically meaningful benefit with regard to psychopathology, behavior and functioning for patients with schizophrenia, and whether variations in the practical administration of ECT influences outcome. Existing research in the field and the new information of research in patients with treatment-resistant schizophrenia (TRS) from Thailand are summarized. Independent of gender, duration of the current episode and severity of baseline negative symptoms predict outcome. Treatment results in marked improvement in positive symptoms, with an intermediate effect on affective symptoms, and no effect or worsening of negative symptoms. The combination of ECT and conventional antipsychotic drug is associated with better outcome than either ECT alone or antipsychotic drug alone during both acute and maintenance phases of treatment. This improvement is not only in psychopathology but also in quality of life and social functioning. Electrical stimulus doses 2-4 times the seizure threshold are likely to increase the speed of recovery with bilateral ECT. Thrice-weekly ECT elicits response faster than does twice-weekly ECT. Although this preliminary evidence supports the use of ECT in patients with TRS, the research base for its use is still inadequate and deserves better investigation.

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Short Courses of E.C.T. and Simulated E.C.T. in Chronic Schizophrenia

Cited by 19 publications

References 8 publications

Electroconvulsive Therapy: Part I. A Perspective on the Evolution and Current Practice of ECT

Electroconvulsive Therapy: Part I. A Perspective on the Evolution and Current Practice of ECT

The Role of ECT in Schizophrenia

Electroconvulsive Therapy for Schizophrenia

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