Table 1.
Characteristics of 22 randomized controlled trials that compare treatment of refractory schizophrenia with combined ECT and antipsychotic medication versus treatment with antipsychotic medication alone
| study |
treatment ECT group/control group |
age ECT group/control group |
sample size ECT group/control group |
trial duration (weeks) |
number of ECT sessions | blind evaluation | outcome measures (change required for ‘improvement’) |
|---|---|---|---|---|---|---|---|
| Chanpatana 1999[11] | ECT+flupenthixol/flupenthixol | 20-49 | 17/18 | 24 | 14 | yes | BPRS; GAF; MMSE |
| Goswami 2003[17] | ECT+chlorpromazine/sham ECT+chlorpromazine | NA | 15/10 | 4 | NA | yes | BPRS(20%) and CGI≤3 or BPRS≤35 |
| Yang 2005[27] | ECT+clozapine/clozapine | NA | 30/30 | 4 | 6-12 | NA | PANSS(20%) |
| Ding 2007[13] | ECT+risperidone/risperidone | 36.5/38.7 | 30/30 | 12 | ≥12 | NA | PANSS(20%); TESS |
| Cai 2008[10] | ECT+clozapine/clozapine | 18-60 | 50/50 | 8 | 6-12 | NA | BPRS(25%); TESS |
| Braga 2009[9] | ECT+clozapine/clozapine | NA | 21/17 | 8 | NA | NA | BPRS(20%) |
| Jiang 2009[18] | ECT+risperidone/risperidone | 38.3/39.7 | 34/35 | 12 | 8-12 | NA | PANSS(50%); TESS; WCST; GAF |
| Zhou 2009[31] | ECT+olanzepine/olanzepine | 43.1/42.2 | 31 /32 | 4 | 8-12 | NA | PANSS(25%); WMS |
| liu 2010a[21] | ETC+various antipsychotics/various antipsychotics | 38.4/39.4 | 37/33 | 4 | 12 | NA | SANS(50%); SAPS(50%) |
| Liu 2010b[22] | ECT+risperidone/clozapine | 28.6/29.6 | 30/30 | 8 | ≥12 | NA | PANSS(25%) |
| Ding 2011[14] | ETC+various antipsychotics/various antipsychotics | 29.8/31.5 | 100/100 | 3-5 | 9-15 | NA | PANSS(50%) |
| Du 2011[15] | ECT+clozapine/clozapine | 38.6 | 30/30 | 8 | 10 | NA | BPRS (25%) |
| Duo 2003[16] | ECT+olanzepine/olanzepine | 43.8/42.7 | 30/30 | 12 | 8-12 | NA | PANSS (25%) |
| Jiang 2011[19] | ECT+various antipsychotics/various antipsychotics | 43.4 | 23/23 | 8 | 17-24 | NA | PANSS (50%); WMS |
| Yang 2011[28] | ECT+risperidone/risperidone | 18-65 | 35/36 | 12 | 12 | NA | PANSS (25%); GAF; TESS |
| Chen 2012[29] | ECT+clozapine/clozapine | 31.9/33.6 | 36/35 | 12 | 7-12 | NA | PANSS (25%) |
| Wang 2012[32] | ECT+quetapine/quetapine | 28.9/29.3 | 31/31 | 8 | 10 | NA | PANSS (25%) |
| Zhang 2012[30] | ECT+olanzepine/olanzepine | 38.4 | 42/42 | 8 | 16 | NA | PANSS (25%); TESS |
| Chen 2013[12] | ECT+various antipsychotics/various antipsychotics | 18-60 | 50/40 | 12 | 8-12 | NA | PANSS (25%) |
| Jiang 2013[20] | ECT+ziprasidone/ziprasidone+clozapine | 21-74 | 81/81 | 8 | 12 | NA | BPRS (25%); TESS |
| Wang 2013[26] | ECT+olanzepine/olanzepine | 45.5 | 36/36 | NA | 10-12 | NA | PANSS (25%) |
| Petrides 2015[23] | ECT+clozapine/clozapine | 18-60 | 20/19 | 8 | 20 | yes | BPRS (40%); MMSE |
ECT, electroconvulsive therapy
NA, data not available
BPRS, Brief Psychiatric Rating Scale[36]
GAF, Global Assessment of Functioning[38]
MMSE, Mini-Mental Status Exam[41]
PANSS,Positive and Negative Syndrome Scale[35]
CGI, Clinical Global Impression[44]
TESS, Treatment Emergent Symptoms Scale[37]
WCST,Wisconsin Card Sort Test[42]
WMS, Weschler Memory Scale[43]
SANS, Scale for Assessment of Negative Symptoms[40]
SAPS, Scale for Assessment of Positive Symptoms[39]
a only had female participants