Electroconvulsive Therapy Alone for Schizophrenia: A Meta-analysis of Randomized, Single-blind, Controlled Trials [RETRACTED]
| Autor: | Zheng-Rong Liu, Wei Zheng, Tong Guo, Gabor S. Ungvari, Xiao-Lan Cao, Harry H X Wang, Chee H. Ng, Yu-Tao Xiang, Stephen J. Seiner, H. F. K. Chiu, Ying-Qiang Xiang |
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| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Risperidone medicine.medical_treatment Neuroscience (miscellaneous) Number needed to harm Akathisia behavioral disciplines and activities 030227 psychiatry Discontinuation law.invention 03 medical and health sciences Psychiatry and Mental health 0302 clinical medicine Electroconvulsive therapy Randomized controlled trial law Internal medicine medicine Paliperidone medicine.symptom Psychology Antipsychotic Psychiatry 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | The journal of ECT. |
| ISSN: | 1533-4112 |
| Popis: | PURPOSE: Electroconvulsive therapy (ECT) is a common treatment in practice for schizophrenia in most developing countries. This is a meta-analysis of the efficacy and safety of ECT alone versus antipsychotic (AP) monotherapy for schizophrenia using randomized, single-blind, controlled trial (RCT) data. METHODS: Two assessors independently extracted data. Standardized and weighted mean difference (SMD/WMD), odds ratios (ORs) ± 95% confidence intervals (CIs), and number needed to harm (NNH) were calculated by Review Manager Version 5.3 and the Comprehensive Meta-Analysis Version 2 software. RESULTS: Five RCTs (n = 365; age, 34.1 ± 4.7 years; percentage of male, 52.8 ± 9.5; range on the Jaded scale, 2-3) were identified and analyzed. Electroconvulsive therapy alone was superior to AP monotherapy with chlorpromazine, haloperidol, paliperidone, clozapine, and risperidone, respectively, regarding symptomatic improvement at last-observation end point (SMD, -0.84; P = 0.02; I = 89%). Improvement with ECT separated from AP as early as weeks 1 to 2 (SMD, -1.26; P = 0.01; I = 89%). Meta-analysis of the end point memory quotient of the Wechsler Memory Scale-Revised, Chinese version, revealed that the ECT alone group had poorer memory performance than the AP group (WMD, -9.34; P < 0.00001; I = 0%), but the difference lost its significance within 2 weeks after ECT (WMD, 0.09 to -6.54; P = 0.11-0.97; I = 0%). Compared with AP monotherapy, ECT was associated with more memory impairment (OR, 14.11; P = 0.004; NNH, 6) but with less akathisia (OR, 0.06; P = 0.0009; NNH, 6), tremor (OR, 0.08; P = 0.02; NNH, 7), and tachycardia (OR, 0.06; P = 0.006; NNH, 5). There were no significant differences in other adverse events and all-cause discontinuation. CONCLUSIONS: Electroconvulsive therapy alone could be an effective and safe treatment option for schizophrenia, with transient memory impairment and headache being the major side effects. |
| Databáze: | OpenAIRE |
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