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Augmentation of clozapine with electroconvulsive therapy in treatment resistant schizophrenia: A systematic review and meta-analysis
| Content Provider | Scilit |
|---|---|
| Author | Lally, John Tully, John Robertson, Dene Stubbs, Brendon Gaughran, Fiona Cabe, James H. Mac |
| Copyright Year | 2016 |
| Description | Journal: Schizophrenia Research The primary aim of this systematic review and meta-analysis was to assess the proportion of patients with Treatment Resistant Schizophrenia (TRS) that respond to ECT augmentation of clozapine (C+ECT). We searched major electronic databases from 1980 to July 2015. We conducted a random effects meta-analysis reporting the proportion of responders to C+ECT in RCTs and open-label trials. Five clinical trials met our eligibility criteria, allowing us to pool data from 71 people with TRS who underwent C+ ECT across 4 open label trials (n=32) and 1 RCT (n=39). The overall pooled proportion of response to C+ECT was 54%, (95% CI: 21.8-83.6%) with some heterogeneity evident (I(2)=69%). With data from retrospective chart reviews, case series and case reports, 192 people treated with C+ECT were included. All studies together demonstrated an overall response to C+ECT of 66% (95% CI: 57.5-74.3%) (83 out of 126 patients responded to C+ECT). The mean number of ECT treatments used to augment clozapine was 11.3. 32% of cases (20 out of 62 patients) with follow up data (range of follow up: 3-468weeks) relapsed following cessation of ECT. Adverse events were reported in 14% of identified cases (24 out of 166 patients). There is a paucity of controlled studies in the literature, with only one single blinded randomised controlled study located, and the predominance of open label trials used in the meta-analysis is a limitation. The data suggests that ECT may be an effective and safe clozapine augmentation strategy in TRS. A higher number of ECT treatments may be required than is standard for other clinical indications. Further research is needed before ECT can be included in standard TRS treatment algorithms. |
| Related Links | https://kclpure.kcl.ac.uk/portal/files/48240310/ECT_Full_Article_S_Res_Dec_2015_Pre_Copy_editing_version.pdf https://core.ac.uk/reader/45314537 http://www.schres-journal.com/article/S092099641630024X/pdf |
| Ending Page | 224 |
| Page Count | 10 |
| Starting Page | 215 |
| ISSN | 09209964 |
| e-ISSN | 15732509 |
| DOI | 10.1016/j.schres.2016.01.024 |
| Journal | Schizophrenia Research |
| Issue Number | 1-3 |
| Volume Number | 171 |
| Language | English |
| Publisher | Elsevier BV |
| Publisher Date | 2016-01-27 |
| Access Restriction | Open |
| Subject Keyword | Journal: Schizophrenia Research Psychiatry and Mental Health Treatment Resistant Schizophrenia Schizoaffective Disorder |
| Content Type | Text |
| Resource Type | Article |
| Subject | Biological Psychiatry Psychiatry and Mental Health |
