Combined electroconvulsive therapy and clozapine in treatment -resistant schizophrenia

1. 1. To assess the eIEcacy and safety of combining electroconvulsive therapy (ECT) and clozapine in patients with treatment-resistant schizophrenia, the authors reviewed use of this combination in four treatment-resistant schizophrenic inpatients and one inpatient with schizophrenia who was intoler...

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Bibliographic Details
Published in:Progress in neuro-psychopharmacology & biological psychiatry 1999-04, Vol.23 (3), p.547-556
Main Authors: Kales, Helen C., Dequardo, John R., Tandon, Rajiv
Format: Article
Language:English
Subjects:
Adult
Aged
Antipsychotic Agents - pharmacology
Antipsychotic Agents - therapeutic use
Associated treatments
Biological and medical sciences
clozapine
Clozapine - pharmacology
Clozapine - therapeutic use
Combined Modality Therapy
Electroconvulsive Therapy
Female
Humans
Male
Medical sciences
Neuropharmacology
Pharmacology. Drug treatments
Psycholeptics: tranquillizer, neuroleptic
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Psychopharmacology
Recurrence
schizophrenia
Schizophrenia - therapy
Treatment Outcome
Treatments
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Summary:1. 1. To assess the eIEcacy and safety of combining electroconvulsive therapy (ECT) and clozapine in patients with treatment-resistant schizophrenia, the authors reviewed use of this combination in four treatment-resistant schizophrenic inpatients and one inpatient with schizophrenia who was intolerant of clozapine doses needed to control her psychosis. 2. 2. The combination of clozapine and bilateral ECT was modestly effective in two treatmentresistant patients and markedly effective in three patients. There was significant overall improvement in patients' Clinical Global Impression (CGI) and Global Assessment of Functioning (OAF) scores ( p < 0.005 and p < 0.0004, respectively), however in patients where marked symptomatic improvement was noted, effects were not sustained. 3. 3. One of the patients that showed dramatic yet transient improvement followed by relapses received maintenance ECT but relapsed despite this. 4. 4. The authors saw no adverse effects in connection with the combination of ECT and clozapine. 5. 5. Supplementing clozapine with a course of bilateral ECT appears to be safe and is effective in some patients with refractory schizophrenia, however its beneficial effects may be short-lived. The long-term impact of ECT on the course of schizophrenia in patients incompletely responsive to clozapine is not fully elucidated.
ISSN:0278-5846
1878-4216
DOI:10.1016/S0278-5846(99)00015-9