ECT effective for schizophrenia but requires further research

ATLANTA — Data presented here indicated electroconvulsive therapy was effective for schizophrenia, but caused adverse cognitive effects in some patients.

“Schizophrenia is a chronic illness often characterized by delusions, hallucinations and so forth,” Tyler Kaster MD, a resident at the University of Toronto, said during a press briefing. “Antipsychotics generally are the mainstay of treatment as recommended by most treatment guidelines. However, unfortunately there’s a very high rate of antipsychotic medication not working. There’s some thought that perhaps electroconvulsive therapy — or ECT — may be able to be used for treatment of this illness. However, currently there is fairly limited information around the use of this technology for patients with schizophrenia.”

To assess clinical efficacy and cognitive effects of ECT for schizophrenia, researchers analyzed clinical records for 144 individuals diagnosed with schizophrenia or schizoaffective disorder who received 171 acute courses of ECT.

Overall, 76.7% of participants responded to ECT.

Treatment response was associated with lack of concomitant antiepileptic medication (17.9% vs. 3.9%, P = .0071), a previous good response to ECT (36.4% vs. 15.4%, P = .0174) and having a primary indication for ECT other than failed pharmacotherapy (89.7% vs. 69.8%, P = .0174).

Treatment response was not associated with age, clozapine treatment or benzodiazepine treatment.

Nine percent of participants had adverse cognitive effects associated with ECT and no other clinical factors were associated with adverse cognitive effects.

“ECT is an effective acute treatment of schizophrenia. We saw three-quarters of our patients respond to this treatment and it’s actually associated with unexpectedly minimal cognitive impairment. However, I think it still highlights there are definite side effects to ECT. [Because of this] we also identified some factors associated with treatment response, which may aid in selecting people for this treatment,” Kaster said. “I think this is a work that highlights the fact that ECT is an important treatment option for these patients who are otherwise suffering as a result of their symptoms.” – by Amanda Oldt

Reference:

Kaster T, et al. ECT augmentation in schizophrenia — clinical effectiveness and cognitive impact: A large retrospective review. Presented at: American Psychiatric Association Annual Meeting; May 14-18, 2016; Atlanta.

Disclosure: Kaster reports no relevant financial disclosures.