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Biomedical subjects

R Kongsakon

Publications and source records attributed to R Kongsakon.

2 recordsLinked to original sources
PubMed1999

Short-term effect of combined ECT and neuroleptic therapy in treatment-resistant schizophrenia.

Treatment-resistant schizophrenia (TRS) is a critical public health concern. Short-term treatment with electroconvulsive therapy (ECT), combined with neuroleptics, may increase the response rate in patients with TRS, when compared with either treatment alone. We conducted an open-trial study in 59 patients with TRS with acute exacerbations, by using bilateral ECT combined with flupenthixol (dose range, 12-24 mg/day). 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. Thirty-one patients were ECT responders by our criteria, 19 were non-responders, and nine were dropouts. The responder group had more male patients, paranoid type, of younger age, shorter duration of illness and duration of the current episode, less family history of schizophrenia, and higher pretreatment GAF scores. They received a lesser number of ECT treatments, a less electrical charge used, and lower doses of flupenthixol (p < 0.05). Both positive and negative symptoms improved (p < 0.05), but positive symptoms responded to a greater extent. This study supports the therapeutic efficacy of combined treatment with ECT and neuroleptic drugs. A consensus in the definition of TRS is urgently required.

Acute Disease↗
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↗