ECT and Paranoid schizophrenia

Im my brothers treatment decision maker. He suffers from paranoid schiziphrenia for many years now. His team now reccomends ECT. ( Electroconvulsive Therapy) has anyone had someone have someone go through ECT for paranoid schizophrenia ? Was it helpful ? Did they have side effects like memory lose ? Did it help their condition ?

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I have no personal experience with this therapy. My son did well with the clozapine which was referred to as the “last resort” medication. I suppose if he had not responded so well my next consideration may have been the ECT. I understand from my research that the process is much safer today than it was years ago so that is good to know and I found this article that I hope helps in some way. I understand the responsibility you have and the decisions you have to make. Get as much feedback as you are able to and research as much as you can until you feel you can make the right decision. Might I ask if your brother has ever been on clozapine and if so how that went? I wish you and your brother all the best going forward. https://www.psychiatryadvisor.com/schizophrenia-and-psychoses/schizophrenia-ect-effective-treatment-cognitive-improvement/article/666780/

Thanks for your help. Yes hes been and still is on clozapine and has been for awhile now. It has helped to some degree but he will relapse and symptoms will return. They have played with dosing and adding other medication but again he will be good for a period of time and than revert back to a psycotic state and have to return to hospital. In the last two years hes been hospitalized at least 6 times. Hes been in hospital now 44 days and ECT is what the recommendation is as well as medication

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Hi hi! ECT is often a last resort but it has had some incredible results. It is usually better for mood symptoms or catatonia but I have seen it work with paranoid symptoms as well. I am a psych nurse (as well as my brother having sz) so I have seen some common reactions. It can cause some short term memory loss but long term memory will usually stay intact. Usually that gets better when the treatment stops. Other side effects include a headache, jaw pain and low energy after the procedure. Most people go for 25-30 treatments and you can start to see results by the halfway point. Treatments are only like 90 seconds long and people go under anesthesia for it. Its so amazing, they can shock the specific part of the brain now to target symptoms. That would be the unilateral or bilateral treatment, your bros pdoc can tell you about that. It has a nasty reputation due to its misuse in the 60s. Many patients recommend it to others after they have gone through it. In my sz pts I have seen : more range of emotion being able to be displayed, less paranoia, quieted the voices to a less distressing level, less visual/tactile hallucinations. So some relief of symptoms. But in others, it hasn’t really worked at all.

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ECT was recommended for our son when he would not take any meds and was seriously catatonic. As guardian, I had to approve it, but it still required his permission. However, when he was so sick that he could not respond, the doctor took him for ECT really as a last resort. From that point, the medical staff convinced him that he needed the treatment, and he complied over a couple months of M/W/F treatments while he was in-patient that eventually moved to weekly. He was discharged from hospital and with some effort on our part, we got him into a residential treatment program. At that time, on a scale of 1-10, he was an 8 or a 9. We felt like we almost had our son back. Unfortunately, a fluke event caused our son to miss one of his treatments and it got delayed a second time, and by then he refused to go. I think he was already going downhill again. Whether this was due to the missed ECT or not we will never know for sure. He was again hospitalized and (long story I won’t share on this post) ECT was finally started again. However, it seems that additional catatonic episode took a toll him. He also reached a point where it seemed he had had too many ECT treatments so they have been stopped. (At that point he had been forced to get treatments at a different facility, and thus, a different doctor, and his care was not really being overseen by any one doctor that knew him.) If we had to do this again given the same scenario, I would do the ECT, but wish it could have continued to be coordinated by the same doctor who really did take an interest in our son.

My partner had ECT and said it really helped him particularly with negative symptoms. He also said that he had some memory issues but, eventually that subsided.

My son had ECT and it didn’t help at all and I will always regret putting him through it.

My older son received ECT treatment during the first year of his illness ,he was 19 at the time , he was severely ill and not responding to medication, at the time he had not tried clozapine, the ECT was really traumatic for him but he did have favorable results, he had 21 treatments and refused any more. He unfortunately continued to suffer with positive and negative symptoms over the next 15 years . He was on clozapine for awhile and it was a miracle drug for him but eventually he developed some side effects that made it impossible to continue on it. He had two amazing years of living without severe symptoms with lots of counseling and support from his fiancé tragically we lost him 1 and 1/2 years ago ,he died while hiking in his favorite woods .He was a fun,loving and utterly fragile soul and we miss him terribly

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I am so sorry for your loss. I’m thankful for the good times that you had and the joy that he brought to your life.

I totally understand your hesitation.
My family has discussed ECT for my SzA brother. We decided that treatment would be the last option, not just for the fact that it’s got the Hollywood drama surrounding misuse. It seems to generally go hand in hand with commitment in a behavioral health facility and has some side effects that impact quality of life short term.
We decided to talk to his doctor about scheduling different therapy options based on my brother’s level of involvement, and in descending order based on how each option would impact my brother’s independence.
I talked to my brother about viewing commitment to a treatment facility and options like ECT as less desirable methods, compared to outpatient treatment, group therapy and one on one therapy. Naturally, he agreed.
However, the number of people who have undergone ECT and afterward state clearly that it helped them is encouraging that there is much merit to that option.

I think if group therapy, medication and quitting weed hadn’t worked, we would be taking steps to seek commitment and ECT by now.

You might look at the book by Kitty Dukakis called Shock . This chronicles her experience with ECT for severe depression . It is insightful .

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