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1748 – Electroconvulsive Treatment In Schizophrenia: a Systematic Review

Published online by Cambridge University Press:  15 April 2020

G. Dominici
Affiliation:
Mental Health and Sensory Functions, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy
L. Longo
Affiliation:
Mental Health and Sensory Functions, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy
G. Marconi
Affiliation:
Mental Health and Sensory Functions, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy
D. Lester
Affiliation:
The Richard Stockton College of New Jersey, Pomona, NJ, USA
G. Serafini
Affiliation:
Mental Health and Sensory Functions, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy
P. Girardi
Affiliation:
Mental Health and Sensory Functions, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy
M. Pompili
Affiliation:
Mental Health and Sensory Functions, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy McLean Hospital, Harvard Medical School, Boston, MA, USA

Abstract

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Introduction

Electroconvulsive therapy (ECT) is a medical treatment that is most effective for mood disorders.It has also been shown to be an effective form of treatment for schizophrenia. However, many unanswered questions remain regarding its role in the management of people with schizophrenia.

Objectives

Evaluate the main indications of ECT in schizophrenia patients.

Aims

To investigate the efficacy of ECT in the treatment of schizophrenic patients, evaluating its effects in the short-term and the long-term, comparing ECT with pharmacotherapy, and assessing the effects of treatment and the main indications for use in patients with schizophrenia.

Methods

A systematic review of the literature was conducted for ECT and schizophrenia. Forty-nine articles from peerreviewed journals were identified.

Results

The most common indication for using ECT for schizophrenia patients was to augment pharmacotherapy, while the most common accompanying symptoms were, in order, catatonia, aggression and suicide. Catatonic patients responded significantly better to ECT than patients with any other subtype of schizophrenia. The combination of ECT with pharmacotherapy can be useful for drug-resistant patients. The use of an ECT-risperidone combination or ECT-clozapine combination in patients non-responsive to prior pharmacotherapy was found to be most effective.

Conclusions

ECT, combined with pharmacotherapy, may be a viable option for a selected group of people with schizophrenia. In particular, the use of ECT is recommended for drug-resistant patients, for schizophrenic patients with catatonia, aggression or suicidal behavior, and when rapid global improvement and reduction of acute symptomatology is desired.

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Copyright
Copyright © European Psychiatric Association 2013
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