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Combined Clozapine and Electroconvulsive Therapy in Clozapine-Resistant Schizophrenia: Clinical and Cognitive Outcomes

Biedermann, Falko MD*; Pfaffenberger, Nicole MSc; Baumgartner, Susanne MD*; Kemmler, Georg PhD*†; Fleischhacker, W. Wolfgang MD*; Hofer, Alex MD*

doi: 10.1097/YCT.0b013e31821a8f05
Online Articles

For treatment-refractory schizophrenia, electroconvulsive therapy (ECT) remains controversial because of its cognitive adverse effects. We report here on clinical and cognitive outcomes of a treatment-resistant schizophrenia patient treated with clozapine and right unilateral ECT.

The patient was administered 300 mg of clozapine and 12 right unilateral ECT sessions. Psychopathology was rated by means of the Positive and Negative Syndrome Scale. The neurocognitive test battery included the Wisconsin Card Sorting Test, the Münchner Gedächtnis Test, an attentional performance test, the Trail Making Test, and the Hamburger-Wechsler Intelligence Test.

The Positive and Negative Syndrome Scale total score decreased, and all cognitive measures improved.

Electroconvulsive therapy would seem to be a safe treatment option for treatment-refractory schizophrenia patients.

From the Departments of *Biological Psychiatry, and †General Psychiatry, Medical University of Innsbruck, Innsbruck, Austria.

Received for publication December 16, 2010; accepted February 11, 2011.

Reprints: Falko Biedermann, MD, Department of Biological Psychiatry, Medical University Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria (e-mail:

All authors qualify for authorship and they do not have a conflict of interest or financial disclosure in connection with the submitted article.

© 2011 Lippincott Williams & Wilkins, Inc.