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Schizophrenia – Biological
Therapies 1
Electroconvulsive Therapy
Electroconvulsive Therapy (ECT)
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How is it administered? (AO1)
Lie down on bed
 Given muscle relaxant and put to sleep
 Electrodes on non-dominant side of brain
 0.6A applied for ½ sec
 Induces seizure of up to 1 minute
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Electroconvulsive Therapy (ECT)
Why use it?
Many positive symptoms of schizophrenia
(hallucinations, delusions etc) seem to involve
deficient functioning of the cognitive system
 Negative symptoms (lack of motivation and
emotion etc) presumably involve deficient
functioning of the brain as a whole
 So it can be argued that it is worth considering
forms of therapy having direct effects on brain
functioning, eg. electroconvulsive therapy to treat
schizophrenia.

Electroconvulsive Therapy (ECT)

Involves passing an electric current through the
head to produce brain seizures.
 Used to result in broken bones, patient terror,
and bad memory loss. However, improvements
have been made over the years, eg.
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strong muscle relaxants to minimise the magnitude of
convulsions
a move away from administering ECT to both brain
hemispheres to applying it only to the non-dominant
hemisphere to reduce memory loss
To address anxiety, anaesthetic is used so that
patients are asleep while receiving ECT.
Electroconvulsive Therapy (ECT)

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Important:
ECT is used in the treatment of schizophrenia, but
much less frequently than in the treatment of
depression
AQA have specified in a recent Examiner’s Report that
“There are some treatments which were used for
schizophrenia in the past but are no longer considered
suitable in most cases, eg ECT. Descriptions of such
treatments are creditworthy but top band answers
should make clear that ECT is now rarely used to
treat Schizophrenia as part of their description.”
ECT - Effectiveness

Adams (2005) undertook a meta-analysis of
recent studies on use of ECT for S
 Found beneficial effects in the short-term, but
smaller than those obtained with drugs
 They suggested ECT be used on those with
schizophrenia who show limited response to
medication alone

Supported by Braga (2005) who reviewed 42
articles in which ECT had been used in
combination with neuroleptic drugs to treat
schizophrenia, found it an effective combo
ECT - Effectiveness
Real-world benefits: Chanpattana (2007)
found that ECT plus drug therapy actally
led to significant improvements in quality
of life and social functioning
 Often produces good symptom reduction
in those who have had little success with
drug therapy
 Can reduce positive symptoms of S
more quickly than other therapies

ECT - Effectiveness
But:
- Less effective when used on its own rather
than in combination with drug therapy
- Relatively ineffective in treating the negative
symptoms of depression, such as lack of
motivation and emotion
- Less effective in the long-term than in the
short-term
- ECT reduces the symptoms of schizophrenia,
but does not produce a cure. Thus, it is a
palliative rather than a curative treatment.
ECT - Appropriateness
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Appropriate:
Very apt therapy: much evidence that
biological factors are of particular importance
in S, and ECT is a biological form of
treatment
S historically regarded as a mental disorder
that was especially difficult to treat, and this
made it appropriate to think in terms of
radical forms of therapy such as ECT
ECT - Appropriateness
Inappropriate:

Possible side effects
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memory loss
cognitive impairments
neurological damage.
over 60% of those who have undergone ECT report
feelings of anxiety afterwards (Batley, 1998)
However in the majority of cases, side effects are
mild and temporary.
ECT - Appropriateness
Inappropriate:

Because we don't have a clear understanding of
why it is effective. It is probable that it affects
neurotransmission and produces structural
changes, but we don't know the details.
 Because it raises ethical issues. Most patients
dislike receiving ECT, and some might be put
under excessive pressure to become involved in
this form of therapy.