Combination of Electroconvulsive Therapy and Clozapine in Treatment-Resistant Schizophrenia

• 발행기관: 대한신경정신의학회
• 저자명: Jung Hyun Kim Tak Youn Jun Gwon Choi Seong Hoon Jeong Hee Yeon Jung Yong Sik Kim In Won Chung
• 간행물 정보: 『Psychiatry Investigation』제15권 제8호, 829~835쪽, 전체 7쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 2018.08.31

영문 초록

Objective_This study aimed to investigate the effectiveness and tolerability of the combination of electroconvulsive therapy (ECT) in patients with clozapine-treated schizophrenia. Methods_Patients with clozapine-treated schizophrenia during five years of pre-determined period were recruited from Electronic Medical Record. Clinical effects of acute ECT on psychotic symptoms were investigated. We also tried to identify predictive variables requiring maintenance treatment of ECT. Results_Fourteen patients received ECT and clozapine and sixteen were treated with clozapine alone. In the ECT group, which could be refined as clozapine-resistance, PANSS total score was significantly reduced by 19.0±9.9 points, corresponding to a reduction rate of 18.5±8.3%. The clinical remission defined as 20% PANSS reduction criteria was achieved at 42.9%. The subscale factors were significantly reduced, among which the negative symptom was the least. There was no difference in demographic and clinical information between patients receiving and not receiving maintenance ECT, and not all patients seemed to need maintenance ECT if clozapine is continued. Conclusion_Combination of ECT and clozapine in patients with clozapine-resistant schizophrenia resulted in a rapid and substantial reduction of psychotic symptoms. Further studies are needed to improve the effectiveness and tolerability of ECT.

목차

INTRODUCTION

METHODS

RESULTS

DISCUSSION

키워드

Electroconvulsive therapy Clozapine Clozapine-treated schizophrenia Clozapine-resistance Maintenance treatment PANSS