Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India.
Asian J Psychiatr. 2022 Jul;73:103132. doi: 10.1016/j.ajp.2022.103132. Epub 2022 Apr 25.
Treatment-resistant schizophrenia (TRS) is a substantial burden to patients, caregivers, and the treating team. There is a lack of robust evidence to support the efficacy of various pharmacological and non-pharmacological measures to augment clozapine in this population. When used in conjunction with clozapine or other combination antipsychotic regimens, maintenance electroconvulsive therapy (M-ECT) can be a potential therapeutic option in preventing symptom exacerbation in TRS. However, there is limited evidence supporting the role of M-ECT in TRS.
To evaluate the efficacy and safety of maintenance electroconvulsive therapy in patients with TRS.
Sociodemographic details, illness characteristics, details of M-ECT procedure, adverse events, and course of the illness were evaluated using a retrospective chart review at a tertiary care psychiatry centre in south India. Scores on Clinical Global Impression-Severity (CGI-S), Social and Occupational Functioning Assessment Scale (SOFAS), and Hindi Mental Status Examination were compared before and after the course of M-ECT.
Seven male and three female patients received M-ECT in the last eight years (range of 22-172 sessions). There was a reduction in hospitalizations for acute exacerbation and significant improvement in the patient's overall functioning without significant adverse effects.
Maintenance ECT can be a safe and effective treatment option for achieving symptom control in the long-term management of refractory schizophrenia. Controlled trials are needed in this area for further evidence.
治疗抵抗性精神分裂症（TRS）给患者、照顾者和治疗团队带来了巨大的负担。缺乏强有力的证据支持各种药理学和非药理学措施来增强氯氮平在这一人群中的疗效。当与氯氮平或其他联合抗精神病药物方案一起使用时，维持性电抽搐治疗（M-ECT）可以成为预防 TRS 症状恶化的潜在治疗选择。然而，支持 M-ECT 在 TRS 中作用的证据有限。
评估维持性电抽搐治疗在 TRS 患者中的疗效和安全性。
在印度南部的一家三级精神病学中心，通过回顾性病历审查评估了社会人口统计学细节、疾病特征、M-ECT 程序细节、不良事件和疾病过程。在接受 M-ECT 治疗前后，使用临床总体印象严重程度量表（CGI-S）、社会和职业功能评估量表（SOFAS）和印地语精神状态检查量表比较了评分。
在过去的八年中，有 7 名男性和 3 名女性患者接受了 M-ECT（范围为 22-172 次）。急性恶化住院次数减少，患者整体功能显著改善，且无明显不良反应。
维持性 ECT 可以作为一种安全有效的治疗选择，用于控制难治性精神分裂症的长期管理中的症状。需要在这一领域进行对照试验，以获得进一步的证据。
