ECT for schizophrenia

Electroconvulsive therapy (ECT) in the treatment of schizophrenia was evaluated in a double-blind trial; the clinical change after ECT was compared with that after a treatment procedure identical to it but for two exceptions--no electricity was used and no convulsion was induced. All patients had paranoid schizophrenia according to Present State Examination criteria and all received standard doses of neuroleptics for at least 2 weeks before random assignment to the two groups. 20 patients completed the trial: 10 had ECT and 10 were in the control group. Treatment was given three times a week, with a minimum of eight treatments and a maximum of twelve. Clinical change was assessed by the Comprehensive Psychiatric Rating Scale. Both groups improved but the improvement of patients receiving ECT was significantly greater than that of controls both after six treatments (p=0.02) and at the end of treatment (p=0.004). Thus the group receiving ECT gained a clear and early advantage compared with the control group, although by 16 weeks there was little difference between the two groups. Possible reasons for this are discussed.