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

Current Opinion in Psychiatry
Wendy NieuwdorpIris E C Sommer

Abstract

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. Stimulation techniques in the treatment of medication-resistant psychosis have shown inconsistent results. Initial results of rTMS for auditory verbal hallucinations (AVH) were promising, but three recent large randomized controlled trials (RCTs) show similar results of rTMS as placebo. tDCS has shown initial promise as a treatment for AVH, but only in case studies and in two small RCTs. Larger studies are needed to define its efficacy. Although psychotic symptoms generally decrease after ECT, its efficacy has not been demonstrated in comparison with placebo. Although previous meta-analyses indicate significant mean effect sizes for rTMS for intractable AVH, three recent large RCTs indicate no effect compared with placebo. The use of tDCS for resistant AVH and ECT for intractable psychosis has s...Continue Reading

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Citations

Oct 4, 2015·Neuroscience and Biobehavioral Reviews·Jasper LooijestijnRutger Goekoop
Feb 2, 2021·CNS Spectrums·Michael A Cummings, Jennifer A O'Day

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