Test Repetition From the Viewpoint of Biological Variation

Amaç: Şizofreni tanılı hastalarda klozapin ile eşzamanlı olarak uygulanan elektrokonvulziv tedavinin daha iyi tedavi yanıtı ve hastanede yatış süresinde kısalmaya neden olma olasılığını incelemek amaçlanmıştır. Yöntemler: Kadın psikiyatri servisimizde 5 yıl boyunca (01.02.2014 ve 01.02.2019 arasında) yatarak tedavi gören şizofreni tanılı hastaların tıbbi kayıtları retrospektif olarak incelendi. Tedavi yanıtını değerlendirmede Klinik Global İzlem – İyileşme (KGİ-İ) ölçeği kullanılmıştı. Bulgular: EKT ile tedavi edilmiş olan 191 olgu içinde; 8 şizofreni olgusu (K-EKT) EKT ve eşzamanlı klozapin ile tedavi edilmiş ve 14 olguya ise (EKT-Ö) önce EKT uygulanmış, sonrasında klozapin tedavisine başlanmıştı. İki grup arasında EKT seans sayıları ve nöbet süreleri açısından anlamlı fark yoktu (p > 0,05). EKT’ ye yanıt oranının (KGİ-İ: 2 ya da 3), K-EKT grubunda %75 (n=6); EKT-Ö grubunda ise %85,7 (n=12) olduğu görüldü. Ortalama KGİ-İ skorları arasında gruplar arasında anlamlı fark yoktu (p > 0,05). K-EKT grubunun hastanede yatış süresi (37,7  14,44 gün), EKT-Ö grubundan (56,0  19,2 gün) daha kısaydı (p = 0,04). EKT seansları sırasında ya da yatışlar süresince ciddi yan etki görülmedi. Sonuç: Her iki uygulamada da tedaviye iyi yanıt yüksek orandaydı ve anlamlı fark yoktu. EKT ile eşzamanlı klozapin uygulamasının hastanede yatış süresini anlamlı oranda kısaltırken ciddi bir komplikasyona ve yan etki artışına neden olmadığı görüldü.

Anahtar Kelimeler:

EKT, Şizofreni, Klozapin

Test Repetition From the Viewpoint of Biological Variation

Purpose: Determining whether adjunctive electroconvulsive therapy (ECT) with clozapine leads to better treatment response and fewer days in hospital for patients with schizophrenia. Methods: Medical records of patients with schizophrenia who were treated with ECT-clozapine combination in our women’s mental health clinic in a period of 5 years (between 01.02.2014 and 01.02.2019) were investigated retrospectively. Clinical Global Impression of Improvement (CGI-I) scale was used for assessing treatment response. Results: Of the 191 cases treated with ECT, there were 8 cases of schizophrenia who were treated with ECT and concomitant clozapine (C-ECT) and 14 cases who were treated with ECT before the initiation of clozapine (ECT-B). Number of ECT sessions and duration of seizures were not significantly different for both groups (p > 0.05). There was good and mild response (CGI-I score of 2 and 3) in 75% of the patients (n=6) for C-ECT and 85.7% of the patients (n=12) for ECT-B. Mean CGI-I scores between the two groups were not significantly different (p > 0.05). Duration of hospitalization for the C-ECT group (37.7  14.44 days) was shorter than the duration of hospitalization for the ECT-B group (56.0  19.2 days) (p = 0.04). No serious adverse events were observed during the ECT sessions or during the index hospitalizations Conclusion: Response rate was high and similar with both of the procedures and the duration of hospitalization was shorter for C-ECT group with no major complication and no significant increase in adverse effects.

Keywords:

ECT, Schizophrenia, Clozapine,

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