Effects of electroconvulsive therapy on oxidative stress in schizophrenia

Electroconvulsive therapy (ECT) is an established treatment for schizophrenia. Oxidative stress has been implicated in its pathophysiology, and Thiobarbituric acid reactive substances (TBARS) are widely used markers of lipid peroxidation. However, the effect of ECT on TBARS levels remains unclear.

To compare changes in TBARS levels in schizophrenia inpatients receiving ECT plus pharmacotherapy versus pharmacotherapy alone and to examine associations between TBARS levels and clinical variables.

Thirty-eight inpatients with schizophrenia were included (ECT + pharmacotherapy: n = 18; pharmacotherapy only: n = 20). Serum TBARS levels were measured at admission and discharge. Clinical severity was assessed using the Clinical Global Impression and Positive and Negative Syndrome Scale. Non-parametric analyses and multiple linear regression were conducted.

TBARS levels did not significantly change from admission to discharge in either the ECT group (median 756.5 vs. 768.5 nmol/L) or the pharmacotherapy group (median 644.0 vs. 693.5 nmol/L). Percentage changes were comparable between groups (9.64% vs. 15.34%). TBARS levels were negatively correlated with age (ρ = -0.441) and illness duration (ρ = -0.333). Regression analysis showed that suicide history was the only significant predictor of TBARS levels (β = -0.402), while treatment modality was not associated with TBARS change.

ECT was not associated with statistically significant changes in TBARS levels; however, these findings should be interpreted cautiously given the exploratory nature of the study, the small sample size, and methodological limitations. The observed associations with clinical variables suggest that oxidative stress markers may have relevance in specific patient subgroups, warranting further investigation.