Transcranial magnetic stimulation, transcranial direct current stimulation and electroconvulsive therapy for medication-resistant psychosis of schizophrenia

  title={Transcranial magnetic stimulation, transcranial direct current stimulation and electroconvulsive therapy for medication-resistant psychosis of schizophrenia},
  author={Wendy Nieuwdorp and Sanne Koops and Metten Somers and Iris E. Sommer},
  journal={Current Opinion in Psychiatry},
Purpose of review Despite adequate antipsychotic treatment, 20–30% of patients with schizophrenia fail to obtain remission from psychosis. Physical stimulation treatments may provide an alternative therapy. In this review, we summarize the most recent studies regarding repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS) and electroconvulsive therapy (ECT) for medication-resistant psychosis in schizophrenia. Recent findings Stimulation techniques… 
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The first part of this review summarizes the pathogenesis of schizophrenia, especially the negative symptoms and cognitive dysfunction from the perspectives of genetics and epigenetics and describes the novel medications and several advanced physical therapies that will optimize the therapeutic strategy for patients with schizophrenia in future.


Examining transcranial direct-current stimulation (tDCS) as a treatment for hallucinations in schizophrenia.
The results show promise for treating refractory auditory verbal hallucinations and other selected manifestations of schizophrenia.
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In patients treated with rTMS, cognitive performance remained constant or improved and memory complaints alleviated, whereas in the ECT group memory recall deficits emerged and memory complained remained.
Theta Burst Transcranial Magnetic Stimulation for Auditory Verbal Hallucinations: Negative Findings From a Double-Blind-Randomized Trial.
Symptom reduction could be achieved in patients with medication-resistant hallucinations, even within 1 week time as both groups showed similar improvement, but effects were general (ie, placebo-effects) rather than specific to treatment with continuous TB-rTMS.
Electroconvulsive therapy for schizophrenia.
Limited evidence suggests that ECT combined with antipsychotic drugs results in greater improvement in mental state than with antippsychotics alone, and there is no evidence that this early advantage for ECT is maintained over the medium to long term.
Electroconvulsive therapy augmentation in clozapine-resistant schizophrenia: a prospective, randomized study.
The augmentation of clozapine with ECT is a safe and effective treatment option and further research is required to determine the persistence of the improvement and the potential need for maintenance treatments.
Short and Long Term Effects of Left and Bilateral Repetitive Transcranial Magnetic Stimulation in Schizophrenia Patients with Auditory Verbal Hallucinations: A Randomized Controlled Trial
The short and long term effects of 1 Hz treatment of the left temporo-parietal junction area in schizophrenia patients with persistent auditory verbal hallucinations, compared to sham stimulation, and added an extra treatment arm of bilateral TPJ area stimulation were studied.