levEffectiveness of Electroconvulsive Therapy Augmentation on Clozapine-Resistant Schizophrenia

• 발행기관: 대한신경정신의학회
• 저자명: HyeSung Kim SeHyun Kim NamYoung Lee TakYoun JeoungHyuk Lee Seunghyun Chung YongSik Kim InWon Chung
• 간행물 정보: 『Psychiatry Investigation』제14권 제1호, 58~62쪽, 전체 5쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 2017.01.31

영문 초록

Objective-This retrospective case series study of the effectiveness of electroconvulsive therapy (ECT) augmentation on clozapine-resistant schizophrenia was conducted by EMR review. Methods-Clozapine-resistance was defined as persistent psychotic symptoms despite at least 12 weeks of clozapine administration with blood levels over 350 ng/mL in order to rule out pseudo-resistance. Seven in-patients who were taking clozapine and treated with ECT were selected. We analyzed the psychopathology and subscales changed by ECT. Results-The average number of ECT sessions was 13.4 (±4.6). Total Positive and Negative Syndrome Scale (PANSS) score was significantly reduced by 17.9 (±12.8) points (p=0.0384) on average, which represented a reduction of 25.5% (±14.3). 71.4% (5/7) of patients were identified as clinical remission, with at least a 20% reduction in PANSS score. PANSS reduction was associated with number of ECT sessions, stimulus level in the final session, and blood clozapine levels before ECT. However, the negative subscale on the PANSS were not reduced by ECT in any patient. We did not observe any persistent adverse cognitive effects. Conclusion-This study supports that ECT augmentation on clozapine-resistant schizophrenia reveals clinically effective and safe. Further research should be done involving a larger number of patients to investigate the effectiveness of clozapine/ECT combination therapy.

목차

INTRODUCTION

METHODS

RESULTS

DISCUSSION

ACKNOWLEDGEMENTS

REFERENCES

키워드

Clozapine-resistant schizophrenia Electroconvulsive therapy Augmentation