Clozapine and Modified Electroconvulsive Therapy (M-ECT) in Treatment Resistant Schizophrenia (TRS) – A Case Report

Authors

Kareena Arora, JSSAHERFollow
Kishor M, JSS Medical College and Hospital, MysuruFollow
Murali M R, JSS Academy of Higher Education and ResearchFollow
Suhas K Mr, JSSAHERFollow

Author ORCID Identifier

https://orcid.org/0009-0007-0363-0445

Corresponding Author

Dr. Kareena Arora

kreenaaro@gmail.com

Abstract

Schizophrenia is psychiatric disorder affecting less than 1% of population that can be devastating, characterized by positive, negative and cognitive symptoms. This can lead to significant functional impairment. Despite intensive and ongoing research, outcomes from best-practice treatment are often suboptimal. Unfortunately, not all the patients respond to antipsychotic medications. Overall estimates suggest that one-fifth to one-half of patients have treatment resistant schizophrenia (TRS).

TRS include failure sequential trial of two different antipsychotics with sufficient dose, duration and adherence as a minimum criterion. TRS represents major clinical challenge.

Clozapine is the only drug approved for TRS as it is the drug that has demonstrated its superiority in effectiveness. Poor response to clozapine is encountered in up to 40–70% of patients with TRS.

Electroconvulsive therapy (ECT) involves the induction of a seizure by the administration of an electrical stimulus via electrodes usually placed bilaterally on the scalp and was introduced as a treatment for schizophrenia in 1938. Modified ECT is ECT given under anesthetic agent. M-ECT used in conjunction with clozapine or other combination antipsychotic regimens, M-ECT can be a potential therapeutic option in preventing symptom exacerbation in TRS. Studies have shown a reduction in hospitalizations for acute exacerbation and significant improvement in the patient's overall functioning without significant adverse effects.

Publication Date

2024

Publisher

JSS Academy of Higher Education & Research

Conflict of Interest

none

Keywords

treatment resistance in psychiatry, ECT, Clozapine

Word Count

1295

Recommended Citation

Arora K, M K, M R M, K S Mr. Clozapine and Modified Electroconvulsive Therapy (M-ECT) in Treatment Resistant Schizophrenia (TRS) – A Case Report. Digital Journal of Clinical Medicine. 2024; 7(1): -. doi: https://doi.org/10.55691/2582-3868.1220

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