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重新审视电休克治疗在精神分裂症中的作用:我们现在处于什么阶段?

Revisiting the role of electroconvulsive therapy in schizophrenia: Where are we now?

作者信息

Teodorczuk Andrew, Emmerson Brett, Robinson Gail

机构信息

School of Medicine, Gold Coast Campus, Griffith University, Southport, QLD, and; The Prince Charles Hospital, Metro North Mental Health, Brisbane, QLD Australia.

The Prince Charles Hospital, Metro North Mental Health, Brisbane, QLD, and; School of Clinical Medicine, University of Queensland, Brisbane, QLD, Australia.

出版信息

Australas Psychiatry. 2019 Oct;27(5):477-479. doi: 10.1177/1039856219860033. Epub 2019 Jul 9.

Abstract

OBJECTIVE

The purpose of this opinion article is to review the recent evidence base in relation to the role of electroconvulsive therapy (ECT) in the management of patients with schizophrenia. Specifically, we explore the efficacy and safety of ECT. Furthermore, consideration is given to the profile of patients who benefit most from ECT, the role of maintenance ECT and what happens when ECT is not given.

CONCLUSION

Our brief review of the evidence suggests that clinical practice in developing countries has not kept up with the growing literature supporting ECT use in schizophrenia. As such, we advocate that ECT should not be a treatment of last resort. Rather, it should be considered more readily as an add-on therapy when there has been a poor response to antipsychotic medications or concerns exist about side effects. Further research is needed into the efficacy of maintenance ECT.

摘要

目的

本观点文章旨在回顾近期关于电休克治疗(ECT)在精神分裂症患者管理中作用的证据基础。具体而言,我们探讨ECT的疗效和安全性。此外,还考虑了从ECT中获益最大的患者特征、维持性ECT的作用以及不进行ECT时会发生什么情况。

结论

我们对证据的简要回顾表明,发展中国家的临床实践未能跟上支持在精神分裂症中使用ECT的不断增长的文献。因此,我们主张ECT不应作为最后的治疗手段。相反,当对抗精神病药物反应不佳或存在副作用担忧时,应更倾向于将其视为一种附加治疗。需要对维持性ECT的疗效进行进一步研究。

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