J Med Assoc Thai 1999; 82 (6):558

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The Use of the Stabilization Period in Electroconvulsive Therapy Research in Schizophrenia : II. Implementation
Chanpattana W Mail, Chakrabhand S , Kirdcharoen N , Tuntirungsee Y , Techakasem P , Prasertsuk Y

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 tlupenthixol (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 tlupenthixol group, and 14 of 15 relapsed in both the group treated with C-ECT alone or tlupenthixol
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.
Key word : Stabilization Period, ECT, Schizophrenia, Prospective Study, Efficacy

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