[Electroconvulsive therapy in schizophrenia].

Abstract

Electroconvulsive therapy (ECT) was initially developed as a treatment for schizophrenia. Currently, the application of ECT for schizophrenia is controversial because of several international guidelines; however, catatonia is acceptable for the indications by all guidelines. Schizophrenic patients with affective, catatonic, and positive symptoms of recent onset may respond favorably to ECT. Additionally, ECT may improve responsivity to pharmacotherapy for some indications. Therefore, a combination of ECT with pharmacotherapy including clozapine may be effective for the pharmacotherapy -resistant schizophrenia. Another argument is that the relapse rate after ECT response is very high compared to that of mood disorders; development of maintenance therapy(pharmacotherapy or ECT) is anticipated for the prevention of relapse. Because maintenance ECT seems to be a burden on remitted patients, to study both maintenance pharmacotherapy and the novel application of non-invasive treatment, such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), for maintenance therapy instead of ECT could be fruitful.