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Electroconvulsive therapy for the treatment of clozapine nonresponders suffering from schizophrenia--an open label study.

Journal European archives of psychiatry and clinical neuroscience
Year 2004
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This article is included in 4 Systematic reviews Systematic reviews (4 references) 1 Broad synthesis Broad syntheses (1 reference)

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OBJECTIVE: This open label study describes the efficacy of electroconvulsive therapy (ECT) as adjunctive treatment in clozapine nonresponders suffering from schizophrenia. METHOD: The results of clozapine and ECT treatment in 11 clozapine nonresponders suffering from schizophrenia are reported in terms of remission and relapse. RESULTS: Eight patients had a remission with this combination treatment. After remission of symptoms five patients had a relapse. Three of the five patients who relapsed had a second successful ECT course and remained well with maintenance ECT and clozapine. No evidence for adverse effects was found. CONCLUSION: Adjunctive ECT can be efficacious in clozapine nonresponders suffering from schizophrenia.

Primary study

Unclassified

Clozapine does not increase ECT-seizure duration.

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Authors Husni M , Haggarty J , Peat C
Journal Canadian journal of psychiatry. Revue canadienne de psychiatrie
Year 1999
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This article is included in 3 Systematic reviews Systematic reviews (3 references) 1 Broad synthesis Broad syntheses (1 reference)

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Primary study

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Combined electroconvulsive therapy and clozapine in treatment-resistant schizophrenia.

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Authors Kales HC , Dequardo JR , Tandon R
Journal Progress in neuro-psychopharmacology & biological psychiatry
Year 1999
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This article is included in 3 Systematic reviews Systematic reviews (3 references) 1 Broad synthesis Broad syntheses (1 reference)

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1. To assess the efficacy and safety of combining electroconvulsive therapy (ECT) and clozapine in patients with treatment-resistant schizophrenia, the authors reviewed use of this combination in four treatment-resistant schizophrenic inpatients and one inpatient with schizophrenia who was intolerant of clozapine doses needed to control her psychosis. 2. The combination of clozapine and bilateral ECT was modestly effective in two treatment-resistant patients and markedly effective in three patients. There was significant overall improvement in patients' Clinical Global Impression (CGI) and Global Assessment of Functioning (GAF) scores (p < 0.005 and p < 0.0004, respectively), however in patients where marked symptomatic improvement was noted, effects were not sustained. 3. One of the patients that showed dramatic yet transient improvement followed by relapses received maintenance ECT but relapsed despite this. 4. The authors saw no adverse effects in connection with the combination of ECT and clozapine. 5. Supplementing clozapine with a course of bilateral ECT appears to be safe and is effective in some patients with refractory schizophrenia, however its beneficial effects may be short-lived. The long-term impact of ECT on the course of schizophrenia in patients incompletely responsive to clozapine is not fully elucidated.

Primary study

Unclassified

Concurrent administration of clozapine and ECT: a successful therapeutic strategy for a patient with treatment-resistant schizophrenia.

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Authors Bhatia SC , Bhatia SK , Gupta S
Journal The journal of ECT
Year 1998
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This article is included in 3 Systematic reviews Systematic reviews (3 references) 1 Broad synthesis Broad syntheses (1 reference)

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A male patient with a 4-year history of schizophrenic disorder, treated in the past with several conventional neuroleptics, atypical antipsychotics, as well as adjunctive therapies, was hospitalized because of treatment resistance/intolerance to pharmacotherapy. During 60 weeks of hospitalization, the patient was treated with conventional neuroleptics or clozapine monotherapy and with concurrent bilateral electroconvulsive therapy (ECT). The patient showed inadequate response to conventional neuroleptics or clozapine without ECT. Concurrent administration of pimozide and ECT resulted in a brief period of improvement. However, concurrent administration of clozapine and ECT resulted in substantial improvement. Our observation suggests that combination treatment with clozapine and ECT can be safe and effective.

Primary study

Unclassified

Neuroleptic-resistant schizophrenia treated with clozapine and ECT.

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Authors Benatov R , Sirota P , Megged S
Journal Convulsive therapy
Year 1996
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This article is included in 4 Systematic reviews Systematic reviews (4 references) 1 Broad synthesis Broad syntheses (1 reference)

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Despite advancement in psychopharmacology, treatment-resistant schizophrenia still poses a challenge to modern psychiatry. We present four patients with schizophrenia treated with clozapine and ECT. One patient who developed neuroleptic malignant syndrome (NMS) on conventional neuroleptics experienced no complications with this combination.

Primary study

Unclassified

Combining Clozapine with ECT.

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Authors Safferman AZ , Munne R
Journal Convulsive therapy
Year 1992
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This article is included in 4 Systematic reviews Systematic reviews (4 references) 1 Broad synthesis Broad syntheses (1 reference)

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We describe the safe and effective use of the combination of clozapine and ECT in a patient with schizophrenia who had lost responsiveness to clozapine alone. We suggest further investigation to define the role of combined clozapine-ECT treatment in the management of treatment-resistant schizophrenia.

Primary study

Unclassified

Clozapine, ECT, and Schizoaffective Disorder, Bipolar Type.

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Authors Klapheke MM
Journal Convulsive therapy
Year 1991
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This article is included in 3 Systematic reviews Systematic reviews (3 references) 1 Broad synthesis Broad syntheses (1 reference)

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Opinions differ regarding the risks and benefits of the concurrent use of antipsychotic medication and ECT. A case example is presented of the safe and effective concurrent use of ECT and the newly available neuroleptic clozapine in a young patient with schizoaffective disorder, bipolar type. The patient's pulse did climb as high as 170-180 beats/min during a few of the seizures. More experience is needed with the combined use of clozapine and ECT.