Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Electroconvulsive Therapy (ECT) Division, The Zucker Hillside Hospital, Northwell Health, Glen Oaks.
Electroconvulsive Therapy (ECT) Service, New York Community Hospital, Brooklyn, New York, USA.
Curr Opin Psychiatry. 2018 May;31(3):213-222. doi: 10.1097/YCO.0000000000000418.
ECT remains an important, yet underutilized, treatment for schizophrenia. Recent research shows that medication-resistant patients with schizophrenia, including those resistant to clozapine, respond well to ECT augmentation. The purpose of this article is to review recent studies of the use of ECT in the treatment of schizophrenia.
We performed an electronic database search for articles on ECT and schizophrenia, published in 2017. The main themes of these articles are: epidemiological data on ECT use from various countries; retrospective studies, prospective studies and meta-analyses focusing on efficacy and cognitive side-effects of ECT in schizophrenia; ECT technical parameters and potential biomarkers.
There is growing evidence to support the use of ECT for augmentation of antipsychotic response in the treatment of schizophrenia. Cognitive side-effects are generally mild and transient. In fact, many studies show improvement in cognition, possibly related to the improvement in symptoms. There is wide variation among countries in the use of ECT for the treatment of schizophrenia. There are also variations in the choice of ECT electrode placement, parameters and schedules. These technical differences are likely minor and should not interfere with the treatment being offered to patients. Further, long-term studies are needed to optimize ECT treatment parameters, to examine the effect of maintenance ECT and to investigate neuroimaging/biomarkers to understand the mechanism of action and identify potential response predictors to ECT.
电抽搐治疗（ECT）仍然是治疗精神分裂症的一种重要但未充分利用的方法。最近的研究表明，包括氯氮平耐药的精神分裂症药物抵抗患者，对 ECT 增效治疗反应良好。本文的目的是回顾最近关于 ECT 在精神分裂症治疗中的应用的研究。
我们对 2017 年发表的关于 ECT 和精神分裂症的文章进行了电子数据库检索。这些文章的主要主题是：来自不同国家的 ECT 使用的流行病学数据；回顾性研究、前瞻性研究和荟萃分析，重点关注 ECT 在精神分裂症中的疗效和认知副作用；ECT 技术参数和潜在生物标志物。
越来越多的证据支持 ECT 用于增效抗精神病治疗，以改善精神分裂症的治疗反应。认知副作用通常是轻微和短暂的。事实上，许多研究表明认知能力有所改善，这可能与症状改善有关。ECT 在治疗精神分裂症方面的应用在各国之间存在很大差异。ECT 电极放置、参数和方案的选择也存在差异。这些技术差异可能很小，不应对提供给患者的治疗产生干扰。此外，还需要进行长期研究来优化 ECT 治疗参数，研究维持 ECT 的效果，并调查神经影像学/生物标志物，以了解作用机制和确定 ECT 的潜在反应预测因子。
