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Electroshock Therapy May Help Schizophrenia

Antipsychotic Medications Still the First Choice for Treatment, Say Researchers
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ECT, Past and Present continued...

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.

From that limited pool, they say there is some evidence that ECT could be helpful for some schizophrenia patients in addition to antipsychotic medications.

"When participants were given ECT alone, mental state was less likely to improve over the medium term than if they were also given antipsychotic drugs," the researchers write.

"Even if the benefit of ECT is short-term, this may be of particular relevance in situations where speed of improvement is important," writes Tharyan.

The researchers say more research is needed and that it would be "unfortunate" if current guidelines precluded ECT as a treatment option, especially for patients "who have exhausted other options or who have limited options to begin with."

They say 20% of people with schizophrenia fail to respond to antipsychotics.

Side Effects

No trial participants were reported to have died during or immediately after ECT.

Data on deaths weren't a priority in the studies, but "the very few deaths that did occur in these trials do not implicate the course of ECT, and, overall, mortality seems to be low," the review notes.

However, some data pointed to a brief and "probably slight" memory impairment stemming from ECT.

A small trial (40 people) from China found greater memory impairment after a course of ECT combined with antipsychotic drugs than with the drugs alone. But after retesting nine weeks later, the researchers reported that memory had improved in both groups, making the difference no longer significant.

The APA says immediate side effects from ECT are rare except for headaches, muscle aches or soreness, nausea, and confusion. Some patients also report partial memory loss of events that occurred days, weeks, or months before ECT. Most of those memories typically return, but patients have reported longer-lasting problems with recall of those memories, says the APA.

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