Schizophrenia electroconvulsive therapy

Shock Therapy. The early 20th century saw the development of the first effective biological treatments for depression, the shock therapies. The first shock treatments used injection of horse serum or insulin. A major advance in treatment occurred with the advent of electroconvulsive therapy (ECT) in 1934. Although initially used to treat schizophrenia, ECT was soon found to be highly effective for other psychiatric disorders including depression and mania. ECT remained the primary biological psychiatric treatment until the widespread release of psychiatric medications in the 1950s. 

Electroconvulsive Therapy (ECT). Introduced in the mid-1930s, ECT was initially used to treat schizophrenia (for which it is not effective) but was later found to be very effective in the treatment of major depression and mania. It gained widespread use and was the primary biological psychiatric treatment until the introduction of newer psychiatric medications in the 1950s. 

Electroconvulsive therapy (ECT) is an established and effective treatment of depression and some forms of schizophrenia. ECT is the treatment of choice in several types of depression (W. Z. Potter and Rudorfer 1993), especially severe depression (American Psychiatric Association Task Force on Electroconvulsive Therapy 1990 W. Z. Potter et al. 1991). The mechanism by which ECT exerts its antidepressant effect is still unknown. Studies of pharmacologically as well as of electrically induced convulsions suggest that the convulsion is a necessary condition for ECT s therapeutic effects (Cerletti and Bird 1938 Lerer 1987 Lerer et al. 1984). However, there is no satisfactory explanation for the clinical efficacy of convulsions. 

Krog-Meyer 1, Kirkegaard C, Kinje B, et al Effects of amitriptyline on the thyrotropin response to TRH in endogenous depression. Psychiatry Res 15 145-151, 1985 Krueger RB, Sackeim HA Electroconvulsive therapy and schizophrenia, in Schizophrenia. Edited by Hirsch SR, Weinberger D. New York, Blackwell, 1995, pp 503-545... 

Tharyan, P. Adams, C. E. 2005, Electroconvulsive therapy for schizophrenia, Cochrane.Database.Syst.Rev., issue. 2, article no. CD000076. 

Catatonic schizophrenia is a controversial syndrome, and there is debate about its etiology and treatment. There has been a report of two cases of catatonic schizophrenia successfully treated with clozapine a 49-year-old woman and a 19-year-old man (18). Both responded to clozapine despite being resistant to several conventional and atypical antipsychotic drugs and, in the second case, a course of electroconvulsive therapy. These two cases are intriguing, because the dose of clozapine required to improve catatonia was about double the dose required to improve psychosis significantly (600 mg/day and 750 mg/day). The two patients had common adverse effects of clozapine the first had mild nocturnal hypersalivation and mild/moderate constipation, and the second had moderate nocturnal hypersalivation. 

The psychotic disorders include schizophrenia, the manic phase of bipolar (manic-depressive) illness, acute idiopathic psychotic illnesses, and other conditions marked by severe agitation. All exhibit major disturbances in reasoning, often with delusions and hallucinations. Several classes of drugs are effective for symptomatic treatment. Antipsychotic agents also are useful alternatives to electroconvulsive therapy (ECT) in severe depression with psychotic features, and sometimes are used in the management of patients with psychotic disorders associated with delirium or dementia or induced by other agents (e.g., stimulants or L-DOPA). 

Haliler F, Reis O, Weirich S, Hoppner J, Pohl B, Buchmann J. A case of catatonia in a 14-year-old girl with schizophrenia treated with electroconvulsive therapy. Z Kinder Jugendpsychiatr Psychother 2013 41(l) 69-74. 

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