Combined Clozapine and Electroconvulsive Therapy in Clozapine-Resistant Schizophrenia Clinical and Cognitive Outcomes

For treatment-refractory schizophrenia, electroconvulsive therapy (ECT) remains controversial because of its cognitive adverse effects. We report here on clinical and cognitive outcomes of a treatment-resistant schizophrenia patient treated with clozapine and right unilateral ECT. The patient was administered 300 mg of clozapine and 12 right unilateral ECT sessions. Psychopathology was rated by means of the Positive and Negative Syndrome Scale. The neurocognitive test battery included the Wisconsin Card Sorting Test, the Munchner Gedachtnis Test, an attentional performance test, the Trail Making Test, and the Hamburger-Wechsler Intelligence Test. The Positive and Negative Syndrome Scale total score decreased, and all cognitive measures improved. Electroconvulsive therapy would seem to be a safe treatment option for treatment-refractory schizophrenia patients.