IS THERE AN OPTIMAL ELECTRODE PLACEMENT FOR PATIENTS WITH SCHIZOPHRENIA UNDERGOING ELECTROCONVULSIVE THERAPY?

作者：*Weng Jun Tan, J. Foo, Kimberly Choo, P. Tor · 发表于：Journal of ECT · 年份：2025 · DOI：10.1093/ijnp/pyae059.296 · 被引用次数：1 · 研究领域：Medicine

Abstract Background Electroconvulsive therapy (ECT) using the 3 common electrode placements, namely bitemporal, bifrontal and right unilateral (RUL) modalities, has been shown to be efficacious in symptom-reduction in patients with schizophrenia (Ali et al., 2019). However, the most efficacious modality for the treatment of schizophrenia has not been ascertained. Furthermore, the benefit of switching ECT modalities after poor response to the initial electrode placement has not been well-studied. Aims And Objectives We hypothesise that different patients with schizophrenia respond well to a particular ECT modality but not to another. These patients would benefit from switching ECT modalities once a lack of response to the initial modality is identified. Hence, we aim to illustrate the twin issues of the optimal ECT modality and the effect of switching ECT modalities after initial non-response in patients with schizophrenia. Method We report a case series of two distinct patients with schizophrenia who underwent multiple courses of both bifrontal and RUL ECT. Their response to ECT was objectively assessed by comparing their scores on the Brief Psychiatric Rating Scale (BPRS) and the Global Assessment of Functioning (GAF) scale prior to the commencement of ECT with their scores after the 6th and 12th sessions of ECT. The Montreal Cognitive Assessment (MoCA) was used to assess for cognitive side effects of ECT. Results Both patients showed good response to at least one previous c...