greater likelihood

of an earlier discharge from the hospital have also been reported. Unfortunately insufficient evidence exists as to whether this early advantage of ECT can be maintained over the medium to long term. Similar to other reports103 limited evidence suggests that greater improvement, can be obtained combining ECT with antipsychotic Inhibitors,research,lifescience,medical drugs. The MK-0518 cost combination of ECT with antipsychotics was superior to either treatment alone.106,108 Clozapine in particular seems to exert synergistic effects with electroconvulsive treatment.109,111 Comparing unilateral and bilateral stimulus administration, no clear advantage of bilateral ECT could be found. An advantage of a longer treatment series with 20 electroconvulsive treatments being more effective than 12 treatments has been reported.108 Therefore, even though initial beneficial

effects may Inhibitors,research,lifescience,medical not. last beyond the short, term in each patient, ECT as an additional treatment, option can be recommended in combination with an antipsychotic medication in treatment-resistant schizophrenia. Electroconvulsive treatment of acute schizoaffective disorders With regard to response to pharmacologic treatments, schizoaffective disorders are similar to the primary affective disorders.112 Similar to the switch risk in bipolar disorders, in schizoaffective disorders mania, may also be induced by highly effective Inhibitors,research,lifescience,medical antidepressant, treatments including ECT.70 Because a high rate of rapid treatment response to electroconvulsive Inhibitors,research,lifescience,medical treatment of mania has been reported,78,113 ECT is suitable in both bipolar manic and schizomanic episodes. In spite of the reported rapid relief of symptoms, 113 ECT in schizoaffective disorders has also been associated with poorer outcome in comparison with the

treatment of affective disorders.114 Nevertheless, good clinical effectiveness in both schizophrenia and schizoaffective disorders has been reported in case series.115,116 In addition, in very large Cochrane reviews, the effectiveness of ECT in schizoaffective disorders has been confirmed.108 Again in case of nonresponsivencss to clozapine due to good effectiveness, the combination with ECT has been Inhibitors,research,lifescience,medical recommended for the treatment of schizoaffective disorders.109 Continuation ECT (C-ECT) in the long-term treatment of schizophrenia and schizoaffective disorders Due to high relapse rates, even in cases of sufficient relapse prevention using adequate Etomidate neuroleptic treatment117 continuation (and maintenance) ECT should be considered as an effective treatment option in case of schizophrenia103,118 or schizoaffective disorders.119 Even if the lack of sufficient evidence for cost-effectiveness and superiority of ECT over neuroleptic continuation treatment has been considered,120 and resource-intensive CECT may not. be a practical solution for some patients,103 it is still an option in preventing relapse in patients not responding sufficiently to pharmacotherapeutic relapse prevention. It.