ECT for patients suffering from clozapine resistant schizophrenia

In the Netherlands electroconvulsive therapy (ECT) is mainly used for treatment of depression. The ECT guidelines from the Nederlandse Vereniging van Psychiatrie (NVVP 2000) broaden the use of ECT. These guidelines recommend the use of ECT for treatment of schizophrenia when an adequate treatment with clozapine has not been efficacious. There is however little evidence for the efficacy of ECT in clozapine resistant schizophrenia. In this study the efficacy of ECT in the treatment of schizophrenia is explored in patients who are still suffering from psychosis despite adequate treatment with clozapine. Patients are randomized in two groups. In the control group patients continue treatment with clozapine. In the treatment group patients receive ECT treatment and clozapine is also continued. The primary outcome criterion is the reduction in positive symptoms of schizophrenia, which is assessed using the Positive and Negative Syndrome Scale (PANSS). In the follow up phase the time to relapse after a successful ECT course is explored. A single blind, prospective, randomized, controlled study design is used.

ECT is effective as treatment of psychosis in patients suffering from clozapine resistant schizophrenia.

Baseline, two weeks, four weeks, six weeks (end point)

Clozapine vs. clozapine + ECT