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Electroconvulsive therapy added to non-clozapine antipsychotic medication for treatment resistant schizophrenia: Meta-analysis of randomized controlled trials
Zheng W.5; Cao X.-L.6; Ungvari G.S.4; Xiang Y.-Q.; Guo T.; Liu Z.-R.2; Wang Y.-Y.; Forester B.P.1; Seiner S.J.1; Xiang Y.-T.3
2016-06-01
Source PublicationPLoS ONE
ISSN19326203
Volume11Issue:6
Abstract

This meta-analysis of randomized controlled trials (RCTs) examined the efficacy and safety of the combination of electroconvulsive therapy (ECT) and antipsychotic medication (except for clozapine) versus the same antipsychotic monotherapy for treatment-resistant schizophrenia (TRS). Two independent investigators extracted data for a random effects metaanalysis and pre-specified subgroup and meta-regression analyses. Weighted and standard mean difference (WMD/SMD), risk ratio (RR) ±95% confidence intervals (CIs), number needed to treat (NNT), and number needed to harm (NNH) were calculated. Eleven studies (n = 818, duration = 10.2±5.5 weeks) were identified for meta-analysis. Adjunctive ECT was superior to antipsychotic monotherapy regarding (1) symptomatic improvement at last-observation endpoint with an SMD of -0.67 (p<0.00001; I2 = 62%), separating the two groups as early as weeks 1-2withanSMDof-0.58(p<0.00001; I2 = 0%); (2) study-defined response (RR = 1.48, p<0.0001) with an NNT of 6 (CI = 4-9) and remission rate (RR = 2.18, p = 0.0002) with an NNTof8(CI=6-16); (3) PANSS positive and general symptom sub-scores at endpoint with a WMD between -3.48 to -1.32 (P = 0.01 to 0.009). Subgroup analyses were conducted comparing double blind/rater-masked vs. open RCTs, those with and without randomization details, and high quality (Jadadadadup analyses were Jadad<3) studies. The ECT-antipsychotic combinationcausedmoreheadache(p=0.02)withanNNHof6(CI=4-11) and memory impairment (p = 0.001) with an NNH of 3 (CI = 2-5). The use of ECT to augment antipsychotic treatment (clozapine excepted) can be an effective treatment option for TRS, with increased frequency of self-reported memory impairment and headache.

DOI10.1371/journal.pone.0156510
URLView the original
Indexed BySCI
Language英语
WOS Research AreaScience & Technology - Other Topics
WOS SubjectMultidisciplinary Sciences
WOS IDWOS:000377564000014
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Cited Times [WOS]:16   [WOS Record]     [Related Records in WOS]
Document TypeJournal article
CollectionFaculty of Health Sciences
Affiliation1.Mental Hospital of Guang Dong Civil Administration
2.Beijing An Ding Hospital, Capital Medical University
3.Wuhan University
4.University of Western Australia
5.Guangzhou Medical University
6.Chinese University of Hong Kong
7.University of Notre Dame Australia
8.Shenzhen Institute of Mental Health and Shenzhen Kangning Hospital
Recommended Citation
GB/T 7714
Zheng W.,Cao X.-L.,Ungvari G.S.,et al. Electroconvulsive therapy added to non-clozapine antipsychotic medication for treatment resistant schizophrenia: Meta-analysis of randomized controlled trials[J]. PLoS ONE,2016,11(6).
APA Zheng W..,Cao X.-L..,Ungvari G.S..,Xiang Y.-Q..,Guo T..,...&Xiang Y.-T..(2016).Electroconvulsive therapy added to non-clozapine antipsychotic medication for treatment resistant schizophrenia: Meta-analysis of randomized controlled trials.PLoS ONE,11(6).
MLA Zheng W.,et al."Electroconvulsive therapy added to non-clozapine antipsychotic medication for treatment resistant schizophrenia: Meta-analysis of randomized controlled trials".PLoS ONE 11.6(2016).
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