Department of Psychiatry and Electroconvulsive Therapy Center, Dongguk University International Hospital, Goyang, South Korea; Institute of Clinical Psychopharmacology, Dongguk University College of Medicine, Goyang, South Korea.
Department of Psychiatry, Eulji University Hospital, Daejeon, South Korea.
Psychiatry Res. 2019 Mar;273:759-766. doi: 10.1016/j.psychres.2019.02.008. Epub 2019 Feb 5.
Electroconvulsive therapy (ECT) has been suggested as a treatment for augmenting the response to clozapine in patients that do not respond well to clozapine alone and maintenance ECT (M-ECT) had also been recommended to sustain improvement. This retrospective study of up to 2 years of observation was conducted to explore whether M-ECT is beneficial for long-term maintenance of the symptom remission elicited by acute ECT. Positive and Negative Syndrome Scale (PANSS) were plotted for each patient and compared using a linear mixed-effect model. A total of thirty-eight patients were followed and classified into three groups: (1) clozapine alone (CZP, n = 15), (2) acute ECT only (A-ECT, n = 11), and (3) acute ECT with M-ECT (M-ECT, n = 12). The mean number and interval of ECT sessions during the maintenance period in the M-ECT group were 39.0 ± 26.7 and 15.6 ± 8.4 days, respectively. The slope of the M-ECT group eventually declined, but that of the A-ECT group gradually increased back to the pre-ECT level. No persistent or serious adverse effects were observed. In conclusion, A-ECT augmented the effect of clozapine, but M-ECT was required for sustaining symptom improvement.
电抽搐治疗（ECT）已被提议作为一种治疗方法，用于增强对氯氮平反应不佳的患者的反应，并且还建议维持性 ECT（M-ECT）以维持改善。这项长达 2 年的观察回顾性研究旨在探讨 M-ECT 是否有益于急性 ECT 引起的症状缓解的长期维持。为每位患者绘制阳性和阴性综合征量表（PANSS），并使用线性混合效应模型进行比较。共随访了 38 名患者，并分为三组：（1）氯氮平单独治疗（CZP，n=15）；（2）仅急性 ECT（A-ECT，n=11）；和（3）急性 ECT 加 M-ECT（M-ECT，n=12）。M-ECT 组在维持期的 ECT 疗程数和间隔分别为 39.0±26.7 和 15.6±8.4 天。M-ECT 组的斜率最终下降，但 A-ECT 组的斜率逐渐回升至 ECT 前水平。未观察到持续或严重的不良反应。总之，A-ECT 增强了氯氮平的疗效，但需要 M-ECT 来维持症状改善。
Zotero 插件