Electroconvulsive Therapy in the Management of Schizophrenia: A Systematic Review in Emergency Nursing Practice

Year : 2025 | Volume : 03 | Issue : 01 | Page : 43 48
    By

    Deeksha Pandey,

  • Divyanshu Dhami,

  1. Tutor, Department of Nursing, School of Nursing, Galgotias University, Uttar Pradesh, India
  2. Tutor, Department of Nursing, Devsthali Vidyapeeth, Uttar Pradesh, India

Abstract

Electroconvulsive therapy (ECT) is a well-established treatment for various psychiatric disorders, including schizophrenia, particularly in cases where patients are resistant to conventional treatments. Schizophrenia, a chronic and severe psychiatric disorder, often presents with a combination of positive symptoms (such as hallucinations and delusions), negative symptoms (such as social withdrawal and emotional blunting), and cognitive impairments. While antipsychotic medications are the primary treatment, approximately 20–30% of individuals with schizophrenia do not respond adequately to these drugs, a condition known as treatment-resistant schizophrenia (TRS). For these patients, ECT has emerged as a crucial adjunctive therapy. This systematic review analyzes randomized controlled trials (RCTs) and observational studies to assess the efficacy, safety, and clinical applicability of electroconvulsive therapy (ECT) in the treatment of schizophrenia, with a particular focus on treatment-resistant cases. The review evaluates the impact of ECT on positive, negative, and cognitive symptoms, key components of schizophrenia symptomatology. Findings indicate that ECT is particularly effective in reducing positive symptoms, providing rapid relief from hallucinations and delusions. In addition, ECT has a moderate effect on negative symptoms, contributing to improvements in emotional engagement and social interaction when combined with ongoing pharmacological treatments. While ECT has shown substantial therapeutic benefits, it is not without risks. Cognitive side effects, particularly short-term memory loss, remain a primary concern. However, recent advancements in ECT technique, such as the use of anesthesia and refined electrode placement, have reduced the incidence of these adverse effects, making ECT a safer option than in the past. This review emphasizes the importance of ECT as an adjunctive treatment in cases of treatment-resistant schizophrenia, while also highlighting the need for further research to optimize treatment protocols and minimize cognitive side effects.

Keywords: Electroconvulsive therapy, schizophrenia, treatment-resistant, psychosis, systematic review, cognitive side effects

[This article belongs to International Journal of Emergency and Trauma Nursing and Practices ]

How to cite this article:
Deeksha Pandey, Divyanshu Dhami. Electroconvulsive Therapy in the Management of Schizophrenia: A Systematic Review in Emergency Nursing Practice. International Journal of Emergency and Trauma Nursing and Practices. 2025; 03(01):43-48.
How to cite this URL:
Deeksha Pandey, Divyanshu Dhami. Electroconvulsive Therapy in the Management of Schizophrenia: A Systematic Review in Emergency Nursing Practice. International Journal of Emergency and Trauma Nursing and Practices. 2025; 03(01):43-48. Available from: https://journals.stmjournals.com/ijetnp/article=2025/view=222155


References

  1. Ali SA, Mathur N, Malhotra AK, Braga RJ. Electroconvulsive Therapy and Schizophrenia: A Systematic Review. Mol Neuropsychiatry. 2019 Apr;5(2):75-83. doi: 10.1159/000497376. Epub 2019 Apr 2. PMID: 31192220; PMCID: PMC6528094.
  2. 2. Rojas M, Ariza D, Ortega Á, Riaño-Garzón ME, Chávez-Castillo M, Pérez JL, Cudris-Torres L, Bautista MJ, Medina-Ortiz O, Rojas-Quintero J, et al. Electroconvulsive Therapy in Psychiatric Disorders: A Narrative Review Exploring Neuroendocrine–Immune Therapeutic Mechanisms and Clinical Implications. International Journal of Molecular Sciences. 2022; 23(13):6918.
  3. 3. Petrides G, Malur C, Braga RJ, Bailine SH, Schooler NR, Malhotra AK, Kane JM, Sanghani S, Goldberg TE, John M, Mendelowitz A. Electroconvulsive therapy augmentation in clozapineresistant schizophrenia: a prospective, randomized study. Am J Psychiatry. 2015 Jan;172(1):52-8. doi: 10.1176/appi.ajp.2014.13060787. Epub 2014 Oct 31. PMID: 25157964.
  4. UK ECT Review Group. Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis. Lancet. 2003 Mar 8;361(9360):799-808. doi: 10.1016/S0140-6736(03)12705-
  5. 5. PMID: 12642045. 5. Rojas M, Ariza D, Ortega Á, Riaño-Garzón ME, Chávez-Castillo M, Pérez JL, Cudris-Torres L, Bautista MJ, Medina-Ortiz O, Rojas-Quintero J, Bermúdez V. Electroconvulsive Therapy in Psychiatric Disorders: A Narrative Review Exploring Neuroendocrine-Immune Therapeutic Mechanisms and Clinical Implications. Int J Mol Sci. 2022 Jun 22;23(13):6918. doi: 10.3390/ijms23136918. PMID: 35805923; PMCID: PMC9266340.
  6. 6. Mukhtar F, Regenold W, Lisanby SH. Recent advances in electroconvulsive therapy in clinical practice and research. Fac Rev. 2023 Jun 7;12:13. doi: 10.12703/r/12-13. PMID: 37313441; PMCID: PMC10259509.
  7. 7. Leiknes KA, Cooke MJ, Jarosch-von Schweder L, Harboe I, Høie B. Electroconvulsive therapy during pregnancy: a systematic review of case studies. Arch Womens Ment Health. 2015 Feb;18(1):1-39. doi: 10.1007/s00737-013-0389-0. Epub 2013 Nov 24. PMID: 24271084; PMCID: PMC4305619.
  8. Rabie N, Shah R, Ray-Griffith S, Coker JL, Magann EF, Stowe ZN. Continuous Fetal Monitoring During Electroconvulsive Therapy: A Prospective Observation Study. Int J Womens Health. 2021 Jan 6;13:1-7. doi: 10.2147/IJWH.S290934. PMID: 33442300; PMCID: PMC7797309.
  9. 9. Salik I, Marwaha R. Electroconvulsive Therapy. [Updated 2022 Sep 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538266/
  10. 10. Bulteau S, Laforgue EJ, Chimot L, Dumont R, Loutrel O, Etcheverrigaray F, Victorri-Vigneau C, Massri A, Vanelle JM, Sauvaget A. Management of Emergency Electroconvulsive Therapy in the Intensive Care Unit for Life-Threatening Psychiatric Conditions: A Case Series. J ECT. 2018 Mar;34(1):55-59. doi: 10.1097/YCT.0000000000000451. PMID: 28937547.

Regular Issue Subscription Review Article
Volume 03
Issue 01
Received 10/01/2025
Accepted 11/02/2025
Published 05/08/2025
Publication Time 207 Days


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