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Electroshock Therapy May Help Schizophrenia

Antipsychotic Medications Still the First Choice for Treatment, Say Researchers
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WebMD Health News

April 21, 2005 -- Electroconvulsive therapy (ECT) may help some schizophreniaschizophrenia patients in combination with medications.

"There is no suggestion that ECT should be a sole treatment or treatment of first choice in schizophrenia," write the researchers, who reviewed 26 clinical trials conducted since the 1960s.

"Antipsychotic drugsAntipsychotic drugs remain the preferential treatment. There is some evidence to suggest that ECT appears to benefit some who have shown a limited response to antipsychotic medication," continues the study, published in The Cochrane Library.

"Also, in those who improve with ECT but relapse in spite of continuing on the prescribed antipsychotics, the continuation of ECT, given at longer intervals, together with antipsychotic drugs could reduce the possibility of relapse in the medium term."

About Schizophrenia

More than 2 million people in the U.S. have schizophrenia, says the National Institute of Mental Health (NIMH).

Schizophrenia is a severe brain disease that interferes with normal brain and mental function. Patients may experience hallucinations, delusions, paranoia, and a significant lack of motivation. It is often disabling and profoundly affects all areas of life.

Medical care can help, but many patients still experience some symptoms throughout their lives, says an NIMH publication on schizophrenia.

Contrary to many Hollywood portrayals, schizophrenia does not involve multiple personalities and is not the same condition as dissociative identity disorder (also called multiple personality disorder or split personality).

ECT, Past and Present

ECT debuted in 1938, say the researchers, who included Prathap Tharyan, head of psychiatry at India's Christian Medical College.

ECT use declined when psychiatric drugs were developed in the 1950s and in light of "public and professional concerns that ECT is invasive and causes brain damage," say the researchers.

Today, ECT is much less risky than those old-time treatments. The NIMH calls it a highly effective treatment for severe depression and notes that "the possibility of long-lasting memory problems, although a concern in the past, has been significantly reduced with modern ECT techniques."

The potential risks and benefits should be carefully reviewed and discussed by people considering ECT, says the NIMH.

Before ECT, patients are given anesthesia and a muscle relaxant. Then, an electrical current is briefly sent to the brain through electrodes place on the head. The electrical stimulation lasts up to eight seconds and produces a short seizure.

A course of ECT usually consists of six to 12 treatments given three times a week for a month or less, says the American Psychiatric Association (APA).

The international trials reviewed by Tharyan and colleagues had a combined total of 1,485 schizophrenia patients, all of whom were adults. A total of 798 participants got ECT.

Tharyan and colleagues weren't thrilled with the amount of research that was available. They looked through five decades of science and found few trials that were relevant.

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