OBJECTIVE: The aim of the study was to examine the efficacy of electroconvulsive therapy (ECT) combined with antipsychotic (AP) medication on symptom profile in patients with a diagnosis of schizophrenia who had received acute psychiatric inpatient treatment. METHODS: In this prospective study, patients were evaluated for inclusion in the study who were diagnosed with schizophrenia according to DSM-IV diagnostic criteria and were to receive ECT. The patients were evaluated using the Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS), and Clinical Global Impression-Improvement (CGI-I) sub-scale before the first session ECT, once following every two subsequent sessions and after the final session. RESULTS: The patients showed significant improvements in BPRS scores at each evaluation compared with their scores at baseline, and a significant clinical improvement was found on the CGI-I sub-scale at the end of treatment. Across all SAPS sub-scores, significant decreases were found, and the symptoms related to hallucinations and positive formal thought disorder showed the most rapid response to treatment. Across all SANS sub-scores, significant decreases were found, and affective flattening or blunting symptoms responded most rapidly to treatment. CONCLUSION: One of the most important findings in the present study of hospitalized patients with acute schizophrenia was the good response to treatment, which provided significant improvements in both positive and negative symptoms. The most rapid response to treatment was found for hallucinations, positive formal thought disorder, and affective flattening or blunting symptoms. The most important limitation of our study may be the small number of cases. In future, well-standardized studies using a double-blinded, comparative, prospective design and including a sufficient number of patients are needed.

Propofol, etomidate, and thiopental are associated with similar safety and efficacy profiles.

Context:Although electroconvulsive therapy (ECT) is considered a very effective tool for the treatment of psychiatric diseases, memory disturbances are among the most important adverse effects.Aims:This study aimed to assess prospectively early subjective memory complaints in depressive and manic patients due to bilateral, brief-pulse ECT, at different stages of the treatment, compare the associations between psychiatric diagnosis, sociodemographic characteristics, and ECT characteristics.Settings and Design:This prospective study was done with patients undergoing ECT between November 2008 and April 2009 at a tertiary care psychiatry hospital of 2000 beds.Materials and Methods:A total of 140 patients, scheduled for ECT with a diagnosis of bipolar disorder (depressive or manic episode) or unipolar depression according to Diagnostic and Statistical Manual of Mental Disorders IV diagnostic criteria, were included in the study and invited to complete the Squire Subjective Memory Questionnaire (SSMQ) before ECT, after the first and third sessions and end of ECT treatment.Statistical Analysis:Mean values were compared with the Kruskal–Wallis test and comparison of the longitudinal data was performed with a nonparametric longitudinal data analysis method, F1_LD_F1 design.Results:SSMQ scores of the patients before ECT were zero. SSMQ scores showed a decrease after the first and third ECT sessions and before discharge, showing a memory disturbance after ECT and were significantly less severe in patients with mania in comparison to those with depression.Conclusions:These findings suggest an increasing degree of subjective memory complaints with bilateral brief-pulse ECT parallel to the increasing number of ECT sessions.

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ÖZETPsikiyatrik hastalıkların tedavisinde kullanılmaya başlandığından beri elektrokonvulzif tedavinin etki ve yan etkileri tartışılmaktadır. Antidepresan etki mekanizmaları birçok araştırmaya konu olmuş, önemli bulgular elde edilmiştir. Ancak yöntemsel farklılıklar ve uygulama protokolündeki değişiklikler araştırmaların ilerlemesinin önünde en büyük engel olmuşlardır. Birçok araştırmada antikonvülzan etki ve nöbet eşiğindeki yükselme ölçü olarak alınmış olmasına karşın bu durum kesinleştirilememiştir. Hastalıklarla ilgili değişkenlerin araştırma bulgularını etkilemiş olma olasılığı bulunmaktadır. Bu yazıda elektokonvulzif tedavinin uygulama biçimleri ve etki mekanizmalarıyla ilgili güncel literatür incelenmiştir. Anahtar Sözcükler: EKT, etki mekanizması, nöbet eşiği, antikonvulzan etki ABSTRACT Effects and side effects of electroconvulsive therapy have been a subject of debate since the beginning of its use to treat psychiatric disorders. As its antidepressant mechanism of action has been topic of many researches, many valuable findings were obtained ever since. However, methodological differences and different application protocols limited the accumulation of scientific data. Anticonvulsant effect and elevation of seizure threshold have been taken as outcome measures in many researches although it is still controversial. Some variables of treated disorders also may have affected researches. The aim of this article was to investigate current literature regarding application protocols and mechanism of action of electroconvulsive therapy.