ECT IN CLOZAPINE REFRACTORY SCHIZOPHRENIA

描述（申请人摘要）：多达30%的精神分裂症患者 对标准抗精神病药物有抵抗力氯氮平代表一种 独特的治疗在我们的医疗设施为精神分裂症，因为它是有帮助的， 治疗30-50%的难治性患者。其中50-70% 不幸的病人对氯氮平没有充分的反应， 没有任何可行的治疗方案他们继续遭受无情的折磨， 对他们的家庭和社会来说是一个相当大的负担。本研究 将研究电休克疗法（ECT）作为一种增强策略， 治疗对氯氮平无效的患者的选择 电休克疗法基于三条证据：在抗精神病药物治疗前， 在药物时代，ECT通常是治疗精神分裂症的有效方法; ECT和抗精神病药物的组合提供了增强的临床 反应;和几个病例系列表明，当ECT被添加到 氯氮平继续氯氮平单药治疗和氯氮平增强治疗联合ECT 在氯氮平难治性精神分裂症患者中， 前瞻性随机分配研究我们会治疗那些 至少12周的充分氯氮平试验。64例受试者（32 随机分配至氯氮平组，32例随机分配至氯氮平+ECT组）， 治疗长达8周; ECT+氯氮平组的受试者将 接受多达16至20次双侧治疗。自然主义的后续行动将 将接受持续ECT治疗的受试者与未接受持续ECT治疗的受试者进行比较， 额外6个月。该研究的结果将指导临床医生面对 如何治疗那些没有得到标准帮助的病人的问题 抗精神病药物，并没有表现出足够的反应，氯氮平。

DESCRIPTION (Applicant's abstract): As many as 30% of schizophrenic patients are resistant to standard antipsychotic medications. Clozapine represents a unique treatment in our armamentarium for schizophrenia as it is helpful in treating 30-50% of the treatment-refractory patients. However, 50-70% of these unfortunate patients do not respond adequately to clozapine, and are left without any viable treatment options. They continue to suffer unrelentingly, and represent a considerable burden to their families and society. This study will investigate electroconvulsive therapy (ECT) as an augmentation strategy for patients who have failed to adequately respond to clozapine. The choice of ECT is based on three converging lines of evidence: in the pre-antipsychotic medication era, ECT was often an effective treatment for schizophrenia; the combination of ECT and antipsychotic medications provides enhanced clinical response; and several case series suggest a benefit when ECT is added to clozapine. Continued clozapine monotherapy and clozapine augmentation with ECT in clozapine refractory schizophrenic patients will be compared in a prospective, random assignment study. We will treat patients who have had at least 12 weeks of an adequate clozapine trial. Sixty-four subjects (32 randomized to clozapine and 32 randomized to clozapine plus ECT) will be treated for up to eight weeks; subjects in the ECT plus clozapine arm will receive up to 16 to 20 bilateral treatments. A naturalistic follow-up will compare subjects who receive continuation ECT with those who do not for an additional 6 months. The results of the study will guide clinicians faced with the problem of how to treat patients who have not been helped by standard antipsychotic medications and do not show an adequate response to clozapine.