Biomedical subjects

N Kirdcharoen

Publications and source records attributed to N Kirdcharoen.

2 recordsLinked to original sources

PubMed1999

The use of the stabilization period in electroconvulsive therapy research in schizophrenia: II. Implementation.

BACKGROUND: Electroconvulsive therapy (ECT) has been used to treat schizophrenia since its inception in 1938. Nonetheless, there has never been a research study documenting the efficacy of ECT in schizophrenia. All ECT studies suffered unexceptable methodological flaws. The authors hypothesized the 3-week stabilization period as: 1) a screening method for ECT responders, 2) a procedure for obtaining a homogeneous group of patients ideally suitable for the continuation treatment study, and, 3) as a part of our relapse criteria. METHOD: One hundred and fourteen schizophrenic patients received acute Phase I treatment with bilateral ECT and flupenthixol (12-24 mg/d). After the first sign of clinical improvement, all patients had to pass a 3-week stabilization period during which their clinical improvement had to be sustained. The patients had to receive at least 20 ECT treatments before being considered unresponsive to ECT. Fifty one patients enrolled in the continuation (Phase II) treatment study, and were randomized to the 3 treatment groups. RESULTS: In Phase I study, 58 patients were ECT responders by our criteria, 43 were nonresponders, and 13 were drop-outs. Forty five patients either relapsed or completed the Phase II study, while 6 patients dropped out. By our relapse criteria, 6 of 15 relapsed in the combined C-ECT and flupenthixol group, and 14 of 15 relapsed in both the group treated with C-ECT alone or flupenthixol alone. The use of the stabilization period in this study could complete all three objectives previously described. CONCLUSIONS: The use of the stabilization period is very useful in ECT research in schizophrenia.

Adolescent↗

PubMed1999

Continuation ECT in treatment-resistant schizophrenia: a controlled study.

In patients with treatment-resistant schizophrenia (TRS), this study compared the efficacy of continuation treatment with flupenthixol alone, continuation electroconvulsive therapy (ECT) alone, and combined continuation ECT and flupenthixol. One hundred fourteen TRS patients received acute treatment (Phase I) with bilateral ECT and flupenthixol (12-24 mg/day). Fifty-eight patients met remitter criteria, including clinical stability during a 3-week stabilization period, and were eligible for the continuation treatment study (Phase II). Fifty-one patients enrolled in the single-blind Phase II continuation trial, and were randomized to the three treatment groups. The duration of the Phase II study was 6 months. Assessments of outcome included the Brief Psychiatric Rating Scale, Global Assessment of Functioning, and the Mini-Mental State Examination. Forty-five patients either relapsed or completed the Phase II study, and six patients dropped out. Among completers, 6 of 15 (40%) patients relapsed in the combined continuation ECT and flupenthixol group. In both the group treated with continuation ECT alone and that with flupenthixol alone, 14 of 15 (93%) patients relapsed. Analyses of intent-to-treat and completer samples demonstrated a marked advantage for the combination treatment condition in relapse prevention. Furthermore, all eight patients who received maintenance ECT combined with neuroleptic medication (Phase III study) maintained therapeutic benefits during the follow-up period of 3-17 months after the continuation treatment study. Among TRS patients who respond to acute combination treatment with ECT and neuroleptic therapy, continuation of this combination treatment is more effective in relapse prevention than use of ECT or neuroleptic therapy alone.

Adult↗