Electroconvulsive therapy: results in depressive illness from the Leicestershire trial. E.C.T. in schizophrenia. The efficacy of electroconvulsive therapy in the treatment of schizophrenia. A comparative study. A controlled trial of modified electroconvulsive therapy in schizophrenia in a Nigerian teaching hospital. A comparison between unidirectional current nonconvulsive electrical stimulation given with Reiter's machine, standard alternating current electro-shock (Cerletti method), and pentothal in chronic schizophrenia. Electroconvulsive therapy in Lorazepam non-responsive catatonia. Unilateral versus bilateral ECT in schizophrenia. An exploratory evaluation of ECT in haloperidol-treated DSM-IIIR schizophreniform disorder. Continuation ECT in treatment-resistant schizophrenia: a controlled study. Effects of stimulus intensity on the efficacy of bilateral ECT in schizophrenia: a preliminary study. Daily administration of unilateral ECT. Role of ect phenothiazine combination in schizophrenia. Reevaluation of ECT in Schizophrenia: Right Temporoparietal versus Bitemporal Electrode Placement. Evaluation of cognitive effects of ect (preliminary observations). Ect-chlorpromazine combination compared with chlorpromazine only in schizophrenia.
Electroconvulsive therapy was investigated in a double blind trial. Altogether 186 clinically selected patients were referred to the trial, but 48 of these did not participate. According to the present state examination, 95 of the remaining 138 patients fell into one of the classes of major depression. Patients were randomly allocated to a course of real or simulated electroconvulsive therapy. Treatment was given twice a week with a maximum of eight treatments. On the Hamilton depressive rating scale the improvement in the group given real treatment was significantly greater than that in the group given simulated treatment both at two weeks (p = 0.014) and at four weeks (p = 0.0001). At follow up at 12 and 28 weeks there was no difference between the treatment groups. At the end of the four week trial consultants, who were blind to the allocation of treatment, rated the patients who had received real treatment as having made a significantly greater improvement than the patients who had received simulated treatment (p less than 0.00005). Further analysis showed that electroconvulsive therapy was effective in depression associated with delusions and in depression associated with retardation. nan The efficacy of ECT was investigated in a double-blind trial. Twenty-two patients with schizophrenia received trifluoperazine and were randomly allocated to receive eight real or eight simulated ECTs. In the first eight weeks, the group receiving real ECTs showed significantly more improvement as measured on the Brief Psychiatric Rating Scale. However, the groups showed no significant differences from the twelfth week onwards. The superiority of real ECT was not confirmed at the end of six months. The efficacy of ECT in the treatment of Schizophrenia was investigated in a double blind controlled trial. The ICD-10 criteria for Schizophrenia were fulfilled by the 20 patients who entered the trial. Consecutive individuals who satisfied the inclusion criteria were randomly allocated to a course of (bilateral) six real or simulated ECTs each as applicable. Sixteen patients completed the ECT treatment and 20 weeks follow up period. Analysis of measures of clinical change (BPRS and SANS Scores) showed that both groups of patients improved, but the improvement of patients receiving ECT was not significantly greater than that of the control group. nan To compare the efficacy of electroconvulsive therapy (ECT) with risperidone in the treatment of lorazepam non-responsive catatonia.
                Inpatients with non-affective catatonia (n= 18) non-responsive to at least five-day trial of lorazepam (6-8 mg/day) were randomised into two groups in a double blind randomised design. Written informed consent was obtained. Four were dropped from the trial as they were found to have depressive catatonia. One group received true ECT (thrice weekly, n=8) plus oral placebo while the other received sham ECT plus risperidone (4-6 mg/ day). Bush-Francis Catatonia Rating Scale (BFCRS) was administered twice weekly to assess improvement in catatonic symptoms over a period of three weeks. The two groups were compared using two-way RMANOVA.
                BFCRS scores reduced markedly over treatment course and this reduction was more profound in the ECT group (p=0.035). Shorter the duration of illness greater was the response (lower scores of BFCRS).
                Superior clinical efficacy of ECT over neuroleptics in catatonia is confirmed by this randomized clinical trial. nan In a double-blind, prospective study, 30 consecutive treatment-naive adult men with first-onset psychosis and DSM-IIIR provisional schizophreniform disorder (without good prognostic features) were randomized into true electroconvulsive therapy (ECT) and sham ECT groups. Both groups received haloperidol in a fixed dose of 15 mg at night. The ECT schedule comprised six bilateral, sinusoidal wave treatments administered on alternate days, thrice a week. Weekly ratings for the first 6 weeks showed an absence of significant difference between the groups in the number of patients responding and in the rate of attenuation of psychosis; severity of depression, while less in the true ECT group after the first 3 weeks, did not differ between the groups at any subsequent time point. Clinical ratings were repeated at 6 months, and social functioning was assessed; again, no group differences emerged. It is concluded that ECT does not meaningfully improve response in unselected schizophreniform disorder that is treated with an adequate dose of neuroleptic. In patients with treatment-resistant schizophrenia (TRS), this study compared the efficacy of continuation treatment with flupenthixol alone, continuation electroconvulsive therapy (ECT) alone, and combined continuation ECT and flupenthixol. One hundred fourteen TRS patients received acute treatment (Phase I) with bilateral ECT and flupenthixol (12-24 mg/day). Fifty-eight patients met remitter criteria, including clinical stability during a 3-week stabilization period, and were eligible for the continuation treatment study (Phase II). Fifty-one patients enrolled in the single-blind Phase II continuation trial, and were randomized to the three treatment groups. The duration of the Phase II study was 6 months. Assessments of outcome included the Brief Psychiatric Rating Scale, Global Assessment of Functioning, and the Mini-Mental State Examination. Forty-five patients either relapsed or completed the Phase II study, and six patients dropped out. Among completers, 6 of 15 (40%) patients relapsed in the combined continuation ECT and flupenthixol group. In both the group treated with continuation ECT alone and that with flupenthixol alone, 14 of 15 (93%) patients relapsed. Analyses of intent-to-treat and completer samples demonstrated a marked advantage for the combination treatment condition in relapse prevention. Furthermore, all eight patients who received maintenance ECT combined with neuroleptic medication (Phase III study) maintained therapeutic benefits during the follow-up period of 3-17 months after the continuation treatment study. Among TRS patients who respond to acute combination treatment with ECT and neuroleptic therapy, continuation of this combination treatment is more effective in relapse prevention than use of ECT or neuroleptic therapy alone. This preliminary study examined the effects of electrical stimulus intensity on the speed of response and efficacy of bilateral electroconvulsive therapy (ECT) in the treatment of schizophrenia.
                Sixty-two patients with schizophrenia received combination treatment with bilateral ECT and flupenthixol. Using a randomized, double-blind design, the effects of three dosages of the ECT electrical stimulus were examined. Patients were treated with a stimulus intensity that was just above seizure threshold, two-times threshold, or four-times threshold. Assessments of outcome used the Brief Psychiatric Rating Scale, Global Assessment of Functioning, and the Mini-Mental State Exam.
                Thirty-three of sixty-two patients met remitter criteria, including maintaining improvement over a 3-week stabilization period. The dosage groups were equivalent in the number of patients who met remitter criteria. The low-dose remitter group (n = 11) received more ECT treatments and required more days to meet remitter status than both the twofold (n = 11) and fourfold remitter groups (n = 11). There was no difference among the groups in change in global cognitive status as assessed by the Mini-Mental State Exam.
                This preliminary study indicates that treatment with high-dosage bilateral ECT speeds clinical response in patients with schizophrenia. There may be a therapeutic window of stimulus intensity in impacting on the efficacy of bilateral ECT, which needs further study. A more sensitive battery of cognitive tests should be used in future research. nan A prospective double blind study was conducted to evaluate the role of E.C.T. in schizophrenia. Before the start of the trial patients were kept on chlorpromazine in adequate dosage for 30 days. Those who showed fifty percent or more improvement during this period were excluded. All patients were given eight modified or simulated E.C.T.s. The patients were followed up for one month. E.C.T. did not show any added advantage over chlorpromazine either initially or during short term follow-up. Two groups of schizophrenic patients received either bitemporal or right temporoparietal electroconvulsive therapy (ECT), both without anesthesia. Each patient received six treatments, the first three at 2-day intervals and the next three at 4-day intervals. Psychiatric evaluations and cognitive tests done at baseline, and 7 and 20 days after therapy, found similar degrees of improvement and similar effects on memory in both groups, with improvement in 40% and impairment in 30% of the patients. Subjective forgetfulness is more often experienced by the patients who receive bilateral ECT. The aim of present double blind controlled study is to evaluate the effects of ECT in Schizophrenia and Depression. 20 depressed and 20 schizophrenic patients of either sex, in the age group 18 to 65 years fulfilling the inclusion and exclusion criteria were taken for study. The psychiatric evaluations were carried out before the treatment, and at the end of 3, 6, 8 and 10 treatments. Cognitive test battery was administered before the treatment and 48 hours after the last treatment. No Post ECT cognitive deficit was observed on the test battery though some patients did complain of forgetfulness subjectively. Forty-four hospitalized schizophrenic patients, 22 in each of two groups, were treated for a period of 6 weeks with either EGT-GPZ combination or CPZ alone. Ratings on RP scale (Rockland and Pollin, 1S65) showed that the KGT-receiving group was significantly better en several measure at second week and also had an earlier onset of beneficial response on "Affect and Mood." However, at the end of 6 weeks, these differences disappeared and on clinical Global Impression of Improvement the two groups did not differ significantly. The implications are discussed.
The evidence in this review suggests that ECT, combined with treatment with antipsychotic drugs, may be considered an option for people with schizophrenia, particularly when rapid global improvement and reduction of symptoms is desired. This is also the case for those with schizophrenia who show limited response to medication alone. Even though this initial beneficial effect may not last beyond the short term, there is no clear evidence to refute its use for people with schizophrenia. The research base for the use of ECT in people with schizophrenia continues to expand, but even after more than five decades of clinical use, there remain many unanswered questions regarding its role in the management of people with schizophrenia.