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Electroconvulsive therapy for treatment-resistant schizophrenia.

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Area of Science:

  • Psychiatry
  • Neurology
  • Clinical Trials

Background:

  • Electroconvulsive therapy (ECT) is a treatment for schizophrenia introduced in 1938.
  • Concerns exist regarding ECT's long-term side effects, such as memory loss.
  • Assessing ECT's efficacy and safety in treatment-resistant schizophrenia is crucial.

Purpose of the Study:

  • To evaluate the benefits and harms of ECT for individuals with treatment-resistant schizophrenia.
  • To compare ECT's effectiveness based on electrode placement (unilateral vs. bilateral) and treatment duration.
  • To determine ECT's differential response in various definitions of treatment-resistant schizophrenia.

Main Methods:

  • Conducted a systematic review of randomized controlled trials.
  • Searched multiple databases without language or date restrictions.
  • Extracted data, calculated risk ratios and mean differences, and assessed risk of bias using the GRADE framework.

Main Results:

  • Moderate-quality evidence suggests ECT improves medium-term clinical response in treatment-resistant schizophrenia compared to standard care.
  • No clear advantage or disadvantage was found for other outcomes when adding ECT to standard care.
  • Evidence was insufficient to compare ECT with sham-ECT or antipsychotics, or to support ECT alone.

Conclusions:

  • ECT demonstrates a positive effect on medium-term clinical response for treatment-resistant schizophrenia.
  • Further high-quality research is required to establish definitive conclusions on ECT's efficacy and safety.
  • The current evidence is limited for comparing ECT with alternative treatments or for its standalone use.