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Journal of ECT:
doi: 10.1097/YCT.0000000000000131
Invited Reviews

The Antipsychotic Effects of ECT: A Review of Possible Mechanisms

Rosenquist, Peter B. MD; Miller, Brian MD, MPH, PhD; Pillai, Anilkumar PhD

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Abstract

Objectives

Electroconvulsive therapy (ECT) exhibits demonstrable effectiveness for psychotic symptoms associated with a broad range of neuropsychiatric conditions. However, the mechanism remains poorly understood particularly with regard to antipsychotic effects.

Methods

We examined studies of ECT in schizophrenia and mood disorders, as well as from animal models of psychotic disorders, and compared the results to those of antipsychotic medications. This review focuses on 3 potential domains of exploration of ECT’s antipsychotic effects: dopamine and serotonin neurotransmitter activity, neurotrophic effects, and immune system modulation.

Results

Preliminary results support a putative role for all three of these domains but are limited by a lack of replicated findings, including negative studies.

Conclusions

A comparison of the neurophysiologic and molecular properties of antipsychotic drugs and ECT reveals some overlap, but there are also distinctive differences; and the significance of these findings remains uncertain.

Copyright © 2014 by Lippincott Williams & Wilkins

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