MECT in TRS: New Case Series From India

 Out on PubMed, from authors in India, is this case series:

Efficacy and safety of maintenance electroconvulsive therapy (M-ECT) in treatment-resistant schizophrenia: A case series.

Purohith AN, Chatorikar SA, Praharaj SK, Bhandary RP, Sharma PSVN.Asian J Psychiatr. 2022 Apr 25;73:103132. doi: 10.1016/j.ajp.2022.103132. Online ahead of print. PMID: 35533602
The abstract is copied below:

Background: Treatment-resistant schizophrenia (TRS) is a substantial burden to patients, caregivers, and the treating team. There is a lack of robust evidence to support the efficacy of various pharmacological and non-pharmacological measures to augment clozapine in this population. When used in conjunction with clozapine or other combination antipsychotic regimens, maintenance electroconvulsive therapy (M-ECT) can be a potential therapeutic option in preventing symptom exacerbation in TRS. However, there is limited evidence supporting the role of M-ECT in TRS.


Aim: To evaluate the efficacy and safety of maintenance electroconvulsive therapy in patients with TRS.

Methodology: Sociodemographic details, illness characteristics, details of M-ECT procedure, adverse events, and course of the illness were evaluated using a retrospective chart review at a tertiary care psychiatry centre in south India. Scores on Clinical Global Impression-Severity (CGI-S), Social and Occupational Functioning Assessment Scale (SOFAS), and Hindi Mental Status Examination were compared before and after the course of M-ECT.

Results: Seven male and three female patients received M-ECT in the last eight years (range of 22-172 sessions). There was a reduction in hospitalizations for acute exacerbation and significant improvement in the patient's overall functioning without significant adverse effects.

Conclusion: Maintenance ECT can be a safe and effective treatment option for achieving symptom control in the long-term management of refractory schizophrenia. Controlled trials are needed in this area for further evidence.
Keywords: Clozapine; ECT; Maintenance electroconvulsive therapy; Treatment-resistant schizophrenia.:

The article is here.

And from the text:




This is a very worthwhile contribution to the evidence base on the efficacy and tolerability of MECT in treatment-resistant schizophrenia. The good tolerability and improved levels of functioning are noteworthy. It is helpful to learn of the HMSE, the Hindi language adaptation of the MMSE.
Kudos to these authors for adding this to the ECT literature.




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