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Review
. 2019 Apr;5(2):75-83.
doi: 10.1159/000497376. Epub 2019 Apr 2.

Electroconvulsive Therapy and Schizophrenia: A Systematic Review

Sana A Ali  1 , Nandita Mathur  1 , Anil K Malhotra  1   2   3 , Raphael J Braga  1   3
Affiliations
Review

Electroconvulsive Therapy and Schizophrenia: A Systematic Review

Sana A Ali et al. Mol Neuropsychiatry. 2019 Apr.

Abstract

Electroconvulsive therapy (ECT) is a remarkably effective treatment for major depressive disorder, but is less commonly utilized for treatment of psychotic disorders. Recent literature indicates that ECT can be a useful strategy for a wide range of psychotic disorders, including treatment-resistant schizophrenia. The purpose of this review is to examine the extant literature on ECT in schizophrenia with a primary focus on its efficacy, its impact on cognitive function, the role of maintenance ECT, and the potential role of neuroimaging biomarkers to provide more precise ECT treatment strategies. We evaluated the available literature, with a particular focus on prospective, randomized trials. Our review suggests that ECT can be an effective treatment strategy in this severely ill patient population. Studies suggest that while ECT in schizophrenia is a safe treatment modality, the potential for cognitive impairment must always be carefully weighed. The use and investigation of new biomarker strategies for the pharmacological treatment of schizophrenia, and the extension of these approaches to ECT are also discussed.

Keywords: Biomarkers; Electroconvulsive therapy; Schizophrenia; Treatment.

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Figures

Fig. 1
Fig. 1
The relationship between the striatal connectivity index and clinical response to treatment in four groups (first episode schizophrenia-responders; first episode schizophrenia-non-responders; generalizability cohort-responders; generalizability cohort-non-responders).
See this image and copyright information in PMC

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