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Electroshock therapy speeds improvement in schizophrenia patients

Shock therapy, a controversial practice conjuring frightening images of behavior control, still has a place in schizophrenia treatment, a newly updated research review shows.

Although the data confirmed that antipsychotic drugs are still the first choice for schizophrenia treatment, they also showed that electroconvulsive, or shock, therapy clearly works, and combining both treatments can accelerate benefits to some patients, the review finds.

Dr. Prathap Tharyan, head of psychiatry at Christian Medical College in Tamil Nadu, India, and colleagues analyzed 26 randomized controlled trials, involving 1,485 adult patients, 798 of whom were treated with shock therapy. Trials were conducted in India, the United States, Thailand, Canada, Hungary and Nigeria.

The review appears in the most recent issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

" The most significant finding is that ECT combined with antipsychotics is more effective than antipsychotics alone in producing rapid clinical improvement in people with schizophrenia," Tharyan said. Rapid improvement of symptoms is potentially lifesaving, for instance, when a person with schizophrenia is suicidal.

The review also refutes a public perception that ECT is dangerous and causes brain damage and suggests that for some patients the side effects of shock therapy may be more tolerable than those of antipsychotic drugs.

ECT induces a seizure with electric stimulus shock, given by electrodes attached to the scalp. Seizures last from 25 to 30 seconds. Patients are given short-acting anesthetics and muscle relaxants to decrease anxiety and protect them from injury during muscle contractions. Patients generally receive ECT two to thr
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Contact: Prathap Tharyan
prathap@cmcvellore.ac.in
Center for the Advancement of Health
20-Apr-2005


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