Work

A clinical control study of modified electroconvulsive therapy and sodium valproate as enhancement strategies for ultra-treatment-resistant schizophrenia

Year: 2025

Type: article

Abstract: Background: A substantial proportion of patients with schizophrenia show an inadequate response to clozapine, a condition termed ultra-treatment-resistant schizophrenia (UTRS). While modified electroconvulsive therapy (MECT) and sodium valproate are common augmentation strategies, head-to-head trials directly comparing their efficacy and safety are lacking. This study aimed to directly compare the short-term efficacy and safety of MECT versus sodium valproate as augmenting agents to clozapine in patients with UTRS. Methods: = 35) or sodium valproate augmentation (n = 35), both in addition to their ongoing clozapine treatment. The primary outcome was the change in the Positive and Negative Syndrome Scale (PANSS) total score. Secondary outcomes included changes in cognitive function assessed by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and laboratory safety parameters. Results: > 0.05). Conclusion: In this cohort of inpatients with UTRS, 8 weeks of MECT augmentation appeared to be more effective than sodium valproate in reducing overall psychotic symptoms. These findings should be considered preliminary, and neither intervention demonstrated short-term benefits for cognitive function. Future studies with longer follow-up periods are warranted to assess the durability of response and should include a clozapine-only control arm to confirm the true value of these augmentation strategies.

Source: Schizophrenia Research Cognition

DOI: 10.1016/j.scog.2025.100396