Estudios primarios incluidos en esta revisión sistemática

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Estudio primario

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Alterations in QT dispersion in medicated schizophrenia patients following electroconvulsive therapy.

Revista European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology
Año 2004
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QT dispersion (QTd) is a measure of interlead variations of the surface 12-lead electrocardiogram (ECG). Increased QTd, found in various cardiac diseases, reflects cardiac instability and is associated with increased risk for cardiac death. Research suggests a link between antipsychotics, ECG abnormalities (QT prolongation) and increased sudden cardiac mortality rates. However, QTd analysis has been scarcely investigated in schizophrenia patients. We calculated QTd in 20 medicated psychotic inpatients with schizophrenia, before and 3 days after electroconvulsive therapy (ECT), concomitantly with Brief Psychiatric Rating Scale (BPRS) assessment. QT interval and the rate-corrected QT (QTc) were abnormally prolonged before ECT. However, although QT was significantly shortened, QTc showed only a marginal decrease after ECT. QTd, the rate-corrected QTd, as well as BPRS, showed a significant decrease after ECT. Further large-scale studies are warranted to determine if QTd can serve as a marker for response to ECT, and if it is a risk factor for sudden cardiac death in schizophrenia patients.

Estudio primario

No clasificado

La terapia electroconvulsiva en el tratamiento de pacientes que no responden clozapina que sufren de esquizofrenia - un estudio abierto.

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Revista European archives of psychiatry and clinical neuroscience
Año 2004
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OBJETIVO: Este estudio abierto describe la eficacia de la terapia electroconvulsiva (TEC) como tratamiento adyuvante en pacientes que no responden clozapina que sufren de esquizofrenia. MÉTODO: Los resultados de la clozapina y tratamiento de TEC en 11 pacientes que no responden clozapina que sufren de esquizofrenia se reportan en términos de remisión y recaída. Resultados: Ocho pacientes tuvieron una remisión con este tratamiento de combinación. Después de la remisión de los síntomas cinco pacientes tuvieron una recaída. Tres de los cinco pacientes que recayeron tenían un segundo curso con éxito TEC y quedaron bien con TEC de mantenimiento y la clozapina. No se encontró evidencia de efectos adversos. CONCLUSIÓN: adyuvante ECT puede ser eficaz en pacientes que no responden clozapina que sufren de esquizofrenia.

Estudio primario

No clasificado

Acute and maintenance ECT with flupenthixol in refractory schizophrenia: sustained improvements in psychopathology, quality of life, and social outcomes.

Autores Chanpattana W , Kramer BA
Revista Schizophrenia research
Año 2003
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OBJECTIVE: To determine the effects of ECT combined with antipsychotic medication therapy on psychopathology, quality of life, and social functioning in patients with refractory schizophrenia. METHOD: An open acute (Phase I) and maintenance (Phase II) study of the combination of ECT and flupenthixol in the treatment of 46 schizophrenic patients who were nonresponsive to antipsychotic medication from at least two different classes. Scales used: the Brief Psychiatric Rating Scale (BPRS), the Quality of Life Scale (QLS), Social and Occupational Functioning Assessment Scale (SOFAS), Global Assessment of Functioning (GAF), and Mini-Mental State Exam (MMSE). The duration of Phase II was 1 year. RESULTS: In Phase I, there were marked reductions in the BPRS scores, and substantial increases in the QLS, SOFAS, GAF, and MMSE scores. During Phase II, the BPRS negative symptoms worsened but remained improved from baseline. Changes in other outcome measures were negligible. CONCLUSION: ECT and MECT combined with flupenthixol were effective in improving psychopathology in patients refractory to antipsychotic medication alone. Ratings of psychopathology, quality of life, and social functioning all improved in Phase I and were generally sustained during Phase II in patients who had remitted.

Estudio primario

No clasificado

Un ensayo controlado de terapia electroconvulsiva modificada en la esquizofrenia en un hospital universitario de Nigeria.

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Revista West African journal of medicine
Año 2003
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La eficacia de la terapia electroconvulsiva en el tratamiento de la esquizofrenia se ha investigado en un ensayo controlado doble ciego. Los criterios de la CIE-10 para la esquizofrenia fueron cumplidas por los 20 pacientes que ingresaron en el ensayo. Individuos consecutivos que cumplían los criterios de inclusión fueron asignados al azar a un curso de (bilateral) seis créditos ECTS cada una, reales o simuladas según corresponda. Dieciséis pacientes completaron el tratamiento con TEC y 20 semanas de seguimiento. Análisis de las medidas del cambio clínico (BPRS y marcadores SANS) mostraron que ambos grupos de pacientes que mejoraron, pero la mejora de los pacientes que reciben terapia electroconvulsiva no fue significativamente mayor que la del grupo control.

Estudio primario

No clasificado

Eficacia de la terapia electroconvulsiva en combinación con antipsicóticos para la esquizofrenia resistente al tratamiento: un estudio prospectivo, abierto.

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Autores Tang WK , Ungvari GS
Revista The journal of ECT
Año 2002
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Este estudio examinó la eficacia a corto plazo de la terapia electroconvulsiva (TEC) en combinación con antipsicóticos para la esquizofrenia resistente al tratamiento (TRS). Quince pacientes con TRS de una unidad de rehabilitación psiquiátrica de pacientes participaron. Los pacientes completaron un curso de la TEC que consta de 8 a 20 sesiones, mientras que sus medicamentos antipsicóticos se continuaron durante todo el estudio. Los pacientes fueron evaluados al inicio del estudio, a 1 semana, 1 mes y 2 meses después de la última sesión de la TEC. Instrumentos de evaluación incluyeron la Escala Breve de Evaluación Psiquiátrica (BPRS), Hamilton Depression Rating Scale, Escala de Evaluación de Síntomas Negativos (SANS), Escala de Evaluación Global (GAS), la Impresión Clínica Global (CGI), Escala de Observación de las enfermeras para In-Paciente evaluación y calificación de los 'pacientes' terapeutas ocupacionales funcionamiento con respecto a las actividades laborales, sociales y de ocio. En comparación con la evaluación inicial, en cada evaluación post-tratamiento, los pacientes mostraron una mejoría estadísticamente significativa en el gas y CGI. Además, eran significativamente mejores en cuanto a las puntuaciones BPRS y SANS, así como el rendimiento laboral y el funcionamiento social en los 2 meses de evaluación post-TEC.

Estudio primario

No clasificado

Effectiveness of ECT combined with risperidone against aggression in schizophrenia.

Autores Hirose S , Ashby CR , Mills MJ
Revista The journal of ECT
Año 2001
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Aggressive behavior in schizophrenic patients can often be problematic not only for the patients themselves, but for their families and others. This study examined the effect of electroconvulsive therapy (ECT) in combination with risperidone in an open trial in 10 male schizophrenic patients with significant aggressive behaviors. Patients were given bilateral ECT five times a week in combination with risperidone. The mean total number of times of ECT was 6.6 (range 5-9). The aggressive behavior in five of the six patients, who showed positive symptoms, was rapidly ameliorated within 12 days. The ECT/risperidone regimen also eliminated aggressive behavior in four patients showing no positive symptoms within 10 days. These treatment effects lasted for at least 6 months in 9 (of the 10) patients. The results suggest that ECT, combined with risperidone, produce a rapid and effective elimination of aggressive behaviors in schizophrenic patients. In addition, there was a resolution of aggression in four patients with no positive symptoms. This suggests that aggression in some schizophrenic patients develops as a primary symptom of schizophrenia and is not related to other positive symptoms of the disease or the patient's personality traits.

Estudio primario

No clasificado

Factors influencing treatment frequency of continuation ECT in schizophrenia.

Revista The journal of ECT
Año 2001
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Although continuation and maintenance electroconvulsive therapy (C-ECT and M-ECT) have been used since 1943, no studies reported data that might help guide the selection of C-ECT frequency. This two-phase study was conducted in 32 chronic schizophrenic patients, with history of prior responsiveness to ECT to determine clinical variables associated with treatment frequency of C-ECT. After acute combination treatment with ECT and neuroleptics (Phase I), all patients received weekly ECT during the first 4 weeks of C-ECT (Phase II). They were then assigned to receive either weekly (n = 8) or biweekly (n = 24) ECT, depending on the history of their prior responsiveness to C-/M-ECT and their Brief Psychiatric Rating Scale (BPRS) scores. At the third month, patients with biweekly ECT were assigned to receive either biweekly (n = 17) or triweekly ECT (n = 7) following the same criteria. The duration of Phase II was 6 months. Onset of illness, numbers of admission, educational level, duration of trials of the previously failed neuroleptics, BPRS scores, and percentage of reductions in BPRS scores at the end of Phase I, Global Assessment of Functioning (GAF) scores at the end of Phase I, Mini-Mental State Exam (MMSE) scores at Phase I entry and Phase I end, and GAF and MMSE scores during the first month of Phase II showed a differentiation between patients having weekly treatment versus biweekly treatment. Whereas a history of previously failed flupenthixol treatment, dosage of flupenthixol used in this study, and MMSE scores at the end of Phase I and during the first month of Phase II showed a differentiation between patients having biweekly C-ECT versus triweekly C-ECT. Our results suggest that the better the prognostic factors for each patient, the longer the frequency of C-ECT.

Estudio primario

No clasificado

Combined ECT and neuroleptic therapy in treatment-refractory schizophrenia: prediction of outcome.

Revista Psychiatry research
Año 2001
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There have been scanty reports of the clinical features of schizophrenic patients treated with electroconvulsive therapy (ECT). This prospective study examined clinical characteristics and predictive factors associated with therapeutic outcome. Two hundred and ninety-three patients with refractory schizophrenia were treated with a combination of ECT and flupenthixol. Outcome assessments included the Brief Psychiatric Rating Scale (BPRS), the Global Assessment of Functioning (GAF), and the Mini-Mental State Examination (MMSE). One hundred and sixty patients (54.6%) met a response criterion. The responders were younger, had shorter durations of illness and current episode, more admissions, and less family history of schizophrenia. The duration of current episode (t=5.0, P<0.0001), followed by baseline GAF score (t=3.1, P=0.002), duration of illness (t=3.1, P=0.002), baseline MMSE score (t=3.0, P=0.003), duration of the previously failed neuroleptic trials (t=3.0, P=0.003), family history of schizophrenia (t=2.1, P=0.03), and paranoid type (t=2.1, P=0.04), could predict the therapeutic outcome. Treatment resulted in marked improvement in positive symptoms but had a minimal effect or led to a worsening of negative symptoms.

Estudio primario

No clasificado

Seizure threshold rise during electroconvulsive therapy in schizophrenic patients.

Revista Psychiatry research
Año 2000
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A rise in seizure threshold during a course of electroconvulsive therapy (ECT) has been demonstrated in patients with depression and mania, but no information has been available as to whether the same result occurs in schizophrenia. Ninety-three patients with schizophrenia underwent estimation of the seizure threshold by the dose-titration method, at the first and second, seventh, fourteenth, and twentieth treatments over an index ECT course. The 3-week stabilization period was used as a response criterion. Eighty-six patients (92%) showed a rise in threshold. The magnitude of increment was 269+/-244%. The rise in seizure threshold could be predicted by the number of treatments, initial seizure threshold and EEG seizure duration, and these factors explained 42% of the variance.

Hilo de publicación

Chanpattana 2000 (Chanpattana 2000)

Este hilo de publicación incluye 2 referencias