The effectiveness of non-clozapine antipsychotics combined with electroconvulsive therapy versus clozapine combined with electroconvulsive therapy for treatment-resistant schizophrenia
The study aimed to compare the effectiveness and safety of other atypical antipsychotics (non-clozapine) plus electroconvulsive therapy (ECT) (NC+ECT) versus clozapine plus ECT (C+ECT) for treating treatment-resistant schizophrenia (TRS). Data of 32 patients with TRS who was receiving ECT were...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Pusat Perubatan Universiti Kebangsaan Malaysia
2021
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| Online Access: | http://journalarticle.ukm.my/18282/ http://journalarticle.ukm.my/18282/1/20_ms0539_pdf_52581.pdf |
| Summary: | The study aimed to compare the effectiveness and safety of other atypical
antipsychotics (non-clozapine) plus electroconvulsive therapy (ECT) (NC+ECT)
versus clozapine plus ECT (C+ECT) for treating treatment-resistant schizophrenia
(TRS). Data of 32 patients with TRS who was receiving ECT were analysed.
We compared clinical characteristics, response to treatment [defined as an
improvement of 40% in the Brief Psychotic Rating Scale (BPRS) psychotic symptom
subscale from pretreatment scores], change of Mini-mental Status Exam (MMSE)
scores, and other adverse effects between the NC+ECT group (N= 16) and C+ECT
group (N =16). We found that the overall response rate was 65.6% (75.8% for
the NC+ECT group and 56.3% for the C+ECT group, p=0.26). The overall BPRS
score in both groups decreased significantly. The mean difference in total BPRS
psychotic subscale score between pre-ECT and after last ECT was 10.4 + 5.8
(p<0.001) for the NC+ECT group and 6.6 + 7.3 (p = 0.002) for the C+ECT group.
When comparing the NC+ECT group to the C+ECT group, the mean difference
in total BPRS psychotic subscale score was not significant. (p = 0.104). The mean
difference in MMSE score between pre-ECT and after the last ECT was -1.1 + 5.1
(p =0.45) for the NC+ECT group and 0.2 + 4.3 (p=0.855) for the C+ECT group. The
change of MMSE score in the NC+ECT group was not significant different compare
to the C+ECT group (p = 0.461). We concluded the combination of antipsychotics
and ECT is an effective and safe treatment option for patients with TRS. Other
NC+ECT groups’ efficacy may be comparable to that of clozapine plus ECT. |
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