Department of Psychiatry,Postgraduate Institute of Medical Education and Research,Chandigarh 160012,India.
Acta Neuropsychiatr. 2019 Jun;31(3):115-127. doi: 10.1017/neu.2018.32. Epub 2018 Dec 3.
Electroconvulsive therapy (ECT) was initially used for the treatment of schizophrenia, but over the years with the advent of antipsychotics, its use in schizophrenia has been limited. Treatment guidelines vary in their recommendations for the use of ECT in schizophrenia. The usual indications of its use among patients with schizophrenia include treatment resistance, to augment pharmacotherapy, to manage catatonia, suicidal behaviour, severe agitation and clozapine-resistant schizophrenia. Available literature, including meta-analysis and systematic reviews, suggest that ECT is a safe and effective treatment in patients with schizophrenia. However, despite the available evidence, it is highly underutilised and is often used as one of the last resort among patients with schizophrenia. This review focuses on the indications of use of ECT in schizophrenia, studies evaluating its effectiveness, efficacy in certain special situations like first episode schizophrenia, adolescents, catatonia etc., predictors of response to ECT in schizophrenia and influence of various ECT-related parameters on efficacy/effectiveness among patients with schizophrenia. From the review, it can be concluded that ECT is not only is beneficial as an augmenting strategy in treatment-resistant schizophrenia but also can be used effectively in patients with schizophrenia in various other situations.
电抽搐治疗（ECT）最初用于治疗精神分裂症，但随着抗精神病药物的出现，其在精神分裂症中的应用受到限制。治疗指南在其关于ECT 在精神分裂症中的应用的建议上存在差异。ECT 在精神分裂症患者中的常用适应证包括治疗抵抗、增强药物治疗、治疗紧张症、自杀行为、严重激越和氯氮平抵抗性精神分裂症。现有文献，包括荟萃分析和系统评价，表明 ECT 是精神分裂症患者安全有效的治疗方法。然而，尽管有现有证据，但ECT 仍未得到充分利用，并且在精神分裂症患者中通常被用作最后手段之一。本综述重点讨论了 ECT 在精神分裂症中的应用适应证、评估其有效性的研究、在某些特殊情况（如首发精神分裂症、青少年、紧张症等）中的疗效、精神分裂症患者对 ECT 反应的预测因素以及各种 ECT 相关参数对患者疗效/有效性的影响。从综述中可以得出结论，ECT 不仅作为治疗抵抗性精神分裂症的增强策略有益，而且在其他各种情况下也可有效用于精神分裂症患者。
