Continuation electroconvulsive therapy in schizophrenia: a pilot study

Continuation and maintenance electroconvulsive therapy (ECT-C & ECT-M) has been used to control schizophrenic patients for more than 50 years. In spite of this, there has been no prospective study made of this treatment. Most of the information comprises naturalistic studies or case reports. As a result many unanswered questions concerning ECT-C & ECT-M remain, including its therapeutic efficacy. This pilot study was prospectively completed on 16 schizophrenic patients, suffering acute exacerbations in order to determine the merits of ECT-C. After acute treatment using only ECT, 12 patients were identified as ECT responders and enrolled in this study. No neuroleptic drugs were used. Diazepam was the only medication prescribed to control agitation on prn basis. The duration of the study was 6 months. Bilateral ECT was used throughout the study, after the acute treatment. Global Assessment of Functioning (GAF), Brief Psychiatric Rating Scale (BPRS) and the Thai Mental State Exam (TMSE) were used to measure the outcome. A total of 8 patients completed the study and 4 dropped out. There were no relapses and all measurements progressed satisfactorily. There were no serious side effects, in particular no cognitive impairment. This study supports the therapeutic efficacy of ECT-C in schizophrenia.