Comparative study of effectiveness of augmentation with ECT in clozapine resistant schizophrenia (CRS) and non-clozapine resistant schizophrenia (Non-CRS)

Abstract

Background

There is limited evidence for different treatment strategies in patients with clozapine resistant schizophrenia (CRS).

Aim

To determine the effectiveness of ECT in patients with clozapine resistant schizophrenia and compare the same with a group of patients with non-clozapine resistant schizophrenia, receiving ECT.

Results

Out of a total of 68 patients with schizophrenia, 27 (38.66%) of patients had CRS. With 6 ECTs, there was a significant reduction in PANSS positive, negative, general psychopathology, prosocial score and depression symptoms in the CRS (p < 0.001) and Non-CRS group (p < 0.001), but no statistically significant difference was seen between the 2 groups in terms of proportion of patients showing >40% response on PANSS total score. The reduction in PANSS score of >40% in CRS group was seen in 48.1% of patients in the positive symptoms subscale, in 25.9% of patients in negative symptoms subscale, in 46.7% of cases in the general psychopathology subscale, in 44.4% of the patients in Depression subscale, in 29.6% of the patients in the modified prosocialsubscaleand in 29.6% of the patients in total PANSS score.

Conclusion

ECT is an effective augmentation strategy for patients with CRS and it is as effective as when used in patients with non-CRS.

Keywords:

• ECT
• schizophrenia
• clozapine resistance

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Sandeep Grover

Sandeep Grover, Professor, in Department of Psychiatry, Post Graduate Institute of Medical Education & Research. His area of interest is severe mental disorders and Consultation-Liaison Psychiatry.

Anish Shouan

Anish Shouan, Former Senior Resident, in Department of Psychiatry, Post Graduate Institute of Medical Education & Research. His area of interest is treatment resistance and community psychiatry.

Subho Chakrabarti

Subho Chakrabarti, Professor, in Department of Psychiatry, Post Graduate Institute of Medical Education & Research. His area of interest is Bipolar Disorder, Schizophrenia and Consultation-Liaison Psychiatry.

Swapnajeet Sahoo

Swapnajeet Sahoo, Assistant Professor, in Department of Psychiatry, Post Graduate Institute of Medical Education & Research. His area of interest is First Episode Psychosis and Consultation-Liaison Psychiatry.

Aseem Mehra

Aseem Mehra, Assistant Professor, in Department of Psychiatry, Post Graduate Institute of Medical Education & Research. His area of interest is severe mental disorders, community psychiatry and geriatric psychiatry.