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Continuation electroconvulsive therapy for relapse prevention in middle-aged and elderly patients with intractable catatonic schizophrenia.
Psychiatry Clin Neurosci. 2005 Aug; 59(4):481-9.PC

Abstract

The authors have previously studied the short-term effect of the first acute electroconvulsive therapy (ECT) course (phase 1 study) on intractable catatonic schizophrenia and the 1-year relapse rate after response to the acute ECT (phase 2 study) in middle-aged and elderly patients. Results indicated that, although acute ECT has an excellent short-term effect, the 1-year relapse rate after response to acute ECT is high despite the use of continuation neuroleptics. In the present prospective study the effect was explored of continuation ECT with neuroleptics on the prevention of relapse after response to a second acute ECT course in the relapsed participants of the phase 2 study. The present study included seven consecutive patients > 45 years of age with catatonic schizophrenia (Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) who relapsed (despite the use of neuroleptics) within 1 year after response to the first acute ECT course, and then responded to the second acute ECT course. The patients were given continuation ECT combined with neuroleptics; four ECT sessions at weekly intervals, then four ECT sessions every 2 weeks, then three ECT sessions every 4 weeks. Clinical symptoms were evaluated by means of the Brief Psychiatric Rating Scale (BPRS) weekly for 48 weeks or until relapse. Relapse was defined as a BPRS score of at least 37 for 3 consecutive days. Three out of the seven patients (42.9%) had a sustained response to ECT during the 1-year follow-up period. In the seven patients the probability of relapse within 1 year under treatment with neuroleptics alone (phase 2 study) was statistically higher than that under continuation ECT combined with neuroleptics (present study). No statistical differences were seen between the phase 2 study and the present study in the severity of psychiatric symptoms, global social function, the number of acute ECT sessions or the dosage of neuroleptics. No patient experienced a severe cognitive or physical adverse effect resulting from continuation ECT. Continuation ECT with neuroleptics is an efficacious and safe treatment for maintaining a response in middle-aged and elderly patients with intractable catatonic schizophrenia who have relapsed after a positive response to acute ECT despite the use of continuation neuroleptics.

Authors+Show Affiliations

Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan. kazumasa-tohoku@umin.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16048455

Citation

Suzuki, Kazumasa, et al. "Continuation Electroconvulsive Therapy for Relapse Prevention in Middle-aged and Elderly Patients With Intractable Catatonic Schizophrenia." Psychiatry and Clinical Neurosciences, vol. 59, no. 4, 2005, pp. 481-9.
Suzuki K, Awata S, Takano T, et al. Continuation electroconvulsive therapy for relapse prevention in middle-aged and elderly patients with intractable catatonic schizophrenia. Psychiatry Clin Neurosci. 2005;59(4):481-9.
Suzuki, K., Awata, S., Takano, T., Ebina, Y., Iwasaki, H., & Matsuoka, H. (2005). Continuation electroconvulsive therapy for relapse prevention in middle-aged and elderly patients with intractable catatonic schizophrenia. Psychiatry and Clinical Neurosciences, 59(4), 481-9.
Suzuki K, et al. Continuation Electroconvulsive Therapy for Relapse Prevention in Middle-aged and Elderly Patients With Intractable Catatonic Schizophrenia. Psychiatry Clin Neurosci. 2005;59(4):481-9. PubMed PMID: 16048455.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Continuation electroconvulsive therapy for relapse prevention in middle-aged and elderly patients with intractable catatonic schizophrenia. AU - Suzuki,Kazumasa, AU - Awata,Shuichi, AU - Takano,Takehisa, AU - Ebina,Yukio, AU - Iwasaki,Hitoshi, AU - Matsuoka,Hiroo, PY - 2005/7/29/pubmed PY - 2005/9/15/medline PY - 2005/7/29/entrez SP - 481 EP - 9 JF - Psychiatry and clinical neurosciences JO - Psychiatry Clin Neurosci VL - 59 IS - 4 N2 - The authors have previously studied the short-term effect of the first acute electroconvulsive therapy (ECT) course (phase 1 study) on intractable catatonic schizophrenia and the 1-year relapse rate after response to the acute ECT (phase 2 study) in middle-aged and elderly patients. Results indicated that, although acute ECT has an excellent short-term effect, the 1-year relapse rate after response to acute ECT is high despite the use of continuation neuroleptics. In the present prospective study the effect was explored of continuation ECT with neuroleptics on the prevention of relapse after response to a second acute ECT course in the relapsed participants of the phase 2 study. The present study included seven consecutive patients > 45 years of age with catatonic schizophrenia (Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) who relapsed (despite the use of neuroleptics) within 1 year after response to the first acute ECT course, and then responded to the second acute ECT course. The patients were given continuation ECT combined with neuroleptics; four ECT sessions at weekly intervals, then four ECT sessions every 2 weeks, then three ECT sessions every 4 weeks. Clinical symptoms were evaluated by means of the Brief Psychiatric Rating Scale (BPRS) weekly for 48 weeks or until relapse. Relapse was defined as a BPRS score of at least 37 for 3 consecutive days. Three out of the seven patients (42.9%) had a sustained response to ECT during the 1-year follow-up period. In the seven patients the probability of relapse within 1 year under treatment with neuroleptics alone (phase 2 study) was statistically higher than that under continuation ECT combined with neuroleptics (present study). No statistical differences were seen between the phase 2 study and the present study in the severity of psychiatric symptoms, global social function, the number of acute ECT sessions or the dosage of neuroleptics. No patient experienced a severe cognitive or physical adverse effect resulting from continuation ECT. Continuation ECT with neuroleptics is an efficacious and safe treatment for maintaining a response in middle-aged and elderly patients with intractable catatonic schizophrenia who have relapsed after a positive response to acute ECT despite the use of continuation neuroleptics. SN - 1323-1316 UR - https://www.unboundmedicine.com/medline/citation/16048455/Continuation_electroconvulsive_therapy_for_relapse_prevention_in_middle_aged_and_elderly_patients_with_intractable_catatonic_schizophrenia_ L2 - https://doi.org/10.1111/j.1440-1819.2005.01402.x DB - PRIME DP - Unbound Medicine ER -