Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Electroshock therapy speeds improvement in schizophrenia patients

21.04.2005


Shock therapy, a controversial practice conjuring frightening images of behavior control, still has a place in schizophrenia treatment, a newly updated research review shows.



Although the data confirmed that antipsychotic drugs are still the first choice for schizophrenia treatment, they also showed that electroconvulsive, or shock, therapy clearly works, and combining both treatments can accelerate benefits to some patients, the review finds.

Dr. Prathap Tharyan, head of psychiatry at Christian Medical College in Tamil Nadu, India, and colleagues analyzed 26 randomized controlled trials, involving 1,485 adult patients, 798 of whom were treated with shock therapy. Trials were conducted in India, the United States, Thailand, Canada, Hungary and Nigeria.


The review appears in the most recent issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

“ The most significant finding is that ECT combined with antipsychotics is more effective than antipsychotics alone in producing rapid clinical improvement in people with schizophrenia,” Tharyan said. Rapid improvement of symptoms is potentially lifesaving, for instance, when a person with schizophrenia is suicidal.

The review also refutes a public perception that ECT is dangerous and causes brain damage and suggests that for some patients the side effects of shock therapy may be more tolerable than those of antipsychotic drugs.

ECT induces a seizure with electric stimulus shock, given by electrodes attached to the scalp. Seizures last from 25 to 30 seconds. Patients are given short-acting anesthetics and muscle relaxants to decrease anxiety and protect them from injury during muscle contractions. Patients generally receive ECT two to three times a week, usually for a total of eight to 12 treatments in a series.

The American Psychiatric Association supports use of ECT only to treat severe, disabling mental disorders. However, the National Institute for Clinical Excellence in the United Kingdom does not recommend general use of ECT for schizophrenia, although it may be indicated for catatonia.

About 2.2 million American adults, or 1.1 percent of the adult population, have schizophrenia, according to 2001 figures from the National Institute of Mental Health. Twenty percent of people with schizophrenia fail to respond to drug therapy alone.

Researchers used sophisticated statistical methods to reach conclusions based on data pooled from individual, randomized studies.

Studies used a variety of tests to measure psychiatric symptoms and psychological, social and occupational functioning.

Ten trials compared shock therapy directly with drug therapy. “When ECT given without antipsychotics is directly compared to treatment with antipsychotics alone … results strongly favor the medication group,” reviewers found. They also found “very limited data” suggesting that people treated with ECT are less likely to relapse.

Further, one trial indicated that the combination of ECT and antipsychotics offered significant advantages that were maintained beyond the short term.

Several trials assessed cognitive side effects, such as memory impairment. Others measured side effects often seen with antipsychotic drugs, such as tremor, slurred speech, inability to keep still, anxiety and paranoia. Some data indicated that these side effects were less severe with ECT than with antipsychotic drugs.

A small trial found more impairment with ECT and antipsychotics combined than antipsychotics alone. “However,” authors noted, “when re-tested nine weeks later, memory function had improved in both groups and no significant differences were detected.”

A very small trial showed a decline in visual memory after ECT compared with those who were given anesthesia and nothing else.

Dr. David Spiegel, professor of psychiatry at Stanford University School of Medicine, has used ECT to treat patients with depression but views its use in schizophrenia as a last resort.

“I would worry that in some of the studies, patients may not have been on an aggressive enough drug schedule to treat early symptoms rapidly,” Spiegel says. “You would have to include only studies where drug control was optimal.

“Lots of people — especially many with delusions — are still uncomfortable with ECT, although it’s terrific for depression,” Spiegel says.

ECT came into use in the late 1930s, but it waned in developed nations with the introduction of antipsychotics and antidepressants in the 1950s.

Tharyan says that in countries with few state-funded social services, ECT can be useful as the more rapid treatment because the impact of long-running schizophrenia can cause both patients and family caregivers to stop working. ECT is more available and less expensive than antipsychotics in many developing areas.

Tharyan P, Adams CE. Electroconvulsive therapy for schizophrenia. The Cochrane Database of Systematic Reviews 2005, Issue 2

The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions.

Prathap Tharyan | EurekAlert!
Further information:
http://www.cochrane.org
http://www.hbns.org
http://www.cfah.org

More articles from Health and Medicine:

nachricht The genes are not to blame
20.07.2018 | Technische Universität München

nachricht Targeting headaches and tumors with nano-submarines
20.07.2018 | Universitätsmedizin der Johannes Gutenberg-Universität Mainz

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Future electronic components to be printed like newspapers

A new manufacturing technique uses a process similar to newspaper printing to form smoother and more flexible metals for making ultrafast electronic devices.

The low-cost process, developed by Purdue University researchers, combines tools already used in industry for manufacturing metals on a large scale, but uses...

Im Focus: First evidence on the source of extragalactic particles

For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.

To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...

Im Focus: Magnetic vortices: Two independent magnetic skyrmion phases discovered in a single material

For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.

Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...

Im Focus: Breaking the bond: To take part or not?

Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.

A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...

Im Focus: New 2D Spectroscopy Methods

Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.

"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Leading experts in Diabetes, Metabolism and Biomedical Engineering discuss Precision Medicine

13.07.2018 | Event News

Conference on Laser Polishing – LaP: Fine Tuning for Surfaces

12.07.2018 | Event News

11th European Wood-based Panel Symposium 2018: Meeting point for the wood-based materials industry

03.07.2018 | Event News

 
Latest News

A smart safe rechargeable zinc ion battery based on sol-gel transition electrolytes

20.07.2018 | Power and Electrical Engineering

Reversing cause and effect is no trouble for quantum computers

20.07.2018 | Information Technology

Princeton-UPenn research team finds physics treasure hidden in a wallpaper pattern

20.07.2018 | Materials Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>