背景:难治性精神分裂症(TRS)对患者来说是一个巨大的负担,看护者,和治疗小组。缺乏有力的证据来支持各种药理学和非药理学措施在该人群中增加氯氮平的功效。与氯氮平或其他联合抗精神病药物联合使用时,维持电惊厥治疗(M-ECT)是预防TRS患者症状加重的潜在治疗选择.然而,支持M-ECT在TRS中的作用的证据有限。
目的:评价TRS患者维持电惊厥治疗的有效性和安全性。
方法:社会人口统计详细信息,疾病特征,M-ECT手术的细节,不良事件,在印度南部的一个三级治疗精神病学中心,采用回顾性图表评价了该疾病的病程.临床总体印象-严重程度(CGI-S)评分,社会和职业功能评估量表(SOFAS)比较M-ECT治疗前后的印地语精神状态检查。
结果:在过去的八年中,有7名男性和3名女性患者接受了M-ECT治疗(范围为22-172次)。急性加重的住院次数减少,患者的整体功能明显改善,无明显不良反应。
结论:在难治性精神分裂症的长期治疗中,维持ECT是一种安全有效的治疗选择,可以实现症状控制。这方面的对照试验需要进一步的证据。
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.
OBJECTIVE: To evaluate the efficacy and safety of maintenance electroconvulsive therapy in patients with TRS.
METHODS: 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.
CONCLUSIONS: 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.