Comparative Study of Clozapine, Electroconvulsive Therapy (ECT), and the Combination of ECT with Clozapine in Treatment-Resistant Schizophrenic Patients

Despite the discovery of new antipsychotic drugs, a number of schizophrenic patients show noresponse to such drugs and are considered treatment-resistant. in such cases, clozapine and occasionally ect ora combination of drugs are used, though they are not very effective. in recent years, the combination of clozapineand ect for treatment-resistant schizophrenic patients has been suggested; the results of preliminary studieshave been hopeful. the aim of this study was to compare the results of treatment with clozapine alone, ectalone, and the combination of clozapine with ect in treatment-resistant schizophrenia.methods: eighteen treatment-resistant schizophrenic patients were assigned to three equal groups: one groupwas given clozapine; one group was treated with ect; and one group was treated with the combination ofclozapine and ect. the treatment response was evaluated using the panss criteria, and the data were analyzedwith anova.results: combination therapy was superior to single modality therapy. the reduction of panss scores was46% in the clozapine group, 40% in the ect groups, and 71% in the combination group; the difference betweenthe combination group and the other groups was statistically significant (p<0.05). patients had a quick responseto combination treatment, which resulted in a higher cure rate of positive and negative symptoms and improvedthe patients’ general performance. there were no significant adverse effects with combination treatment.conclusion: combination treatment with clozapine and ect was safe and effective in treatment-resistantschizophrenic patients. it should be considered for the treatment of treatment-resistant schizophrenic patients.iranian journal of psychiatry and behavioral sciences (ijpbs) , volume 1, number 1, spring and summer 2007 : 7-11 .