Seizure activity in combined clozapine and ECT: a retrospective view.

We examined the medical records of electroconvulsive therapy (ECT) recipients who concurrently received clozapine (n = 7). The patients tolerated ECT, with standard electrical stimulus parameters, without complications. No patients had tardive seizures. The seizure duration during ECT increased, as recorded by electroencephalogram and cuff technique, nonsignificantly by a mean of +2.4 s (range of duration: 17-54 s) while on clozapine. Patient response as evaluated with Brief Psychiatric Rating Scale scores showed a total improvement of 26.9%, improvement in positive signs of schizophrenia of 25.3%, and improvement in negative signs of 21.3%. Hallucinatory behavior (41.7%) and disorganization (45.5%) were markedly reduced. Combined clozapine and ECT appears as safe as other neuroleptics with ECT, with comparable clinical improvements.