Electroconvulsive therapy (ECT) has been recognized as an effective treatment for schizophrenia. However, its clinical utilization has been declining due to advancements in antipsychotic medications and the persistent stigma associated with the treatment. Clinical guidelines differ in their recommendations regarding the applications of ECT in schizophrenia treatment. Existing studies demonstrated that ECT is effective for treatment-resistant schizophrenia, clozapine-resistant schizophrenia, acute psychotic exacerbations, and patients at high risk of suicide, with enhanced efficacy when combined with antipsychotic medications. Despite its clinical benefits, concerns regarding cognitive impairment, social stigma, and limited accessibility have led to its underutilization. Addressing these challenges requires expanding educational efforts for clinicians, increasing public awareness, promoting further research into its long-term efficacy and cognitive effects, and implementing policy changes to improve accessibility. This review emphasizes the essential role of ECT in schizophrenia treatment and the need to reintegrate it as a viable and necessary treatment option for suitable patients.

The mechanism of electroconvulsive therapy (ECT) in schizophrenia remains unclear, with limited research available. Previous studies have reported ECT-induced changes in protein markers, including neurotrophic factors, inflammatory markers, and signaling proteins, but findings have been inconsistent. This study reviews existing literature on protein changes associated with ECT and explores potential molecular mechanisms underlying its effects. Additionally, we present pilot findings from 34 patients with schizophrenia or schizoaffective disorder who underwent ECT at Seoul National University Hospital. Blood samples collected before and after ECT were analyzed via liquid chromatography-tandem mass spectrometry (LC-MS/MS) to identify differentially expressed proteins (DEPs), with Pearson’s correlation analysis examining their association with symptom changes. Talin 2 emerged as a potential biomarker linked to clinical improvement. However, given the small sample size, these findings require cautious interpretation. Further research is needed to clarify the molecular mechanisms underlying ECT’s therapeutic effects in schizophrenia.

This review synthesizes research findings on the structural and functional brain changes observed after electroconvulsive therapy (ECT) in patients with schizophrenia. Structural neuroimaging studies suggest that the hippocampus, amygdala, and right insular cortex are the most critical areas implicated in ECT-related changes for these patients. Functional neuroimaging studies also highlight the involvement of the hippocampus, amygdala, and insular cortex, along with the prefrontal cortex, default mode network, and thalamostriatal system. We examine and discuss the potential implications of these incorporated findings. Given the relative scarcity of related studies, further research is needed to elucidate the mechanisms underlying the effects of ECT in patients with schizophrenia.

Electroconvulsive therapy (ECT) has been recognized as an effective treatment for schizophrenia. However, its clinical utilization has been declining due to advancements in antipsychotic medications and the persistent stigma associated with the treatment. Clinical guidelines differ in their recommendations regarding the applications of ECT in schizophrenia treatment. Existing studies demonstrated that ECT is effective for treatment-resistant schizophrenia, clozapine-resistant schizophrenia, acute psychotic exacerbations, and patients at high risk of suicide, with enhanced efficacy when combined with antipsychotic medications. Despite its clinical benefits, concerns regarding cognitive impairment, social stigma, and limited accessibility have led to its underutilization. Addressing these challenges requires expanding educational efforts for clinicians, increasing public awareness, promoting further research into its long-term efficacy and cognitive effects, and implementing policy changes to improve accessibility. This review emphasizes the essential role of ECT in schizophrenia treatment and the need to reintegrate it as a viable and necessary treatment option for suitable patients.

The mechanism of electroconvulsive therapy (ECT) in schizophrenia remains unclear, with limited research available. Previous studies have reported ECT-induced changes in protein markers, including neurotrophic factors, inflammatory markers, and signaling proteins, but findings have been inconsistent. This study reviews existing literature on protein changes associated with ECT and explores potential molecular mechanisms underlying its effects. Additionally, we present pilot findings from 34 patients with schizophrenia or schizoaffective disorder who underwent ECT at Seoul National University Hospital. Blood samples collected before and after ECT were analyzed via liquid chromatography-tandem mass spectrometry (LC-MS/MS) to identify differentially expressed proteins (DEPs), with Pearson’s correlation analysis examining their association with symptom changes. Talin 2 emerged as a potential biomarker linked to clinical improvement. However, given the small sample size, these findings require cautious interpretation. Further research is needed to clarify the molecular mechanisms underlying ECT’s therapeutic effects in schizophrenia.

This review synthesizes research findings on the structural and functional brain changes observed after electroconvulsive therapy (ECT) in patients with schizophrenia. Structural neuroimaging studies suggest that the hippocampus, amygdala, and right insular cortex are the most critical areas implicated in ECT-related changes for these patients. Functional neuroimaging studies also highlight the involvement of the hippocampus, amygdala, and insular cortex, along with the prefrontal cortex, default mode network, and thalamostriatal system. We examine and discuss the potential implications of these incorporated findings. Given the relative scarcity of related studies, further research is needed to elucidate the mechanisms underlying the effects of ECT in patients with schizophrenia.

Electroconvulsive therapy (ECT) has been recognized as an effective treatment for schizophrenia. However, its clinical utilization has been declining due to advancements in antipsychotic medications and the persistent stigma associated with the treatment. Clinical guidelines differ in their recommendations regarding the applications of ECT in schizophrenia treatment. Existing studies demonstrated that ECT is effective for treatment-resistant schizophrenia, clozapine-resistant schizophrenia, acute psychotic exacerbations, and patients at high risk of suicide, with enhanced efficacy when combined with antipsychotic medications. Despite its clinical benefits, concerns regarding cognitive impairment, social stigma, and limited accessibility have led to its underutilization. Addressing these challenges requires expanding educational efforts for clinicians, increasing public awareness, promoting further research into its long-term efficacy and cognitive effects, and implementing policy changes to improve accessibility. This review emphasizes the essential role of ECT in schizophrenia treatment and the need to reintegrate it as a viable and necessary treatment option for suitable patients.

The mechanism of electroconvulsive therapy (ECT) in schizophrenia remains unclear, with limited research available. Previous studies have reported ECT-induced changes in protein markers, including neurotrophic factors, inflammatory markers, and signaling proteins, but findings have been inconsistent. This study reviews existing literature on protein changes associated with ECT and explores potential molecular mechanisms underlying its effects. Additionally, we present pilot findings from 34 patients with schizophrenia or schizoaffective disorder who underwent ECT at Seoul National University Hospital. Blood samples collected before and after ECT were analyzed via liquid chromatography-tandem mass spectrometry (LC-MS/MS) to identify differentially expressed proteins (DEPs), with Pearson’s correlation analysis examining their association with symptom changes. Talin 2 emerged as a potential biomarker linked to clinical improvement. However, given the small sample size, these findings require cautious interpretation. Further research is needed to clarify the molecular mechanisms underlying ECT’s therapeutic effects in schizophrenia.

This review synthesizes research findings on the structural and functional brain changes observed after electroconvulsive therapy (ECT) in patients with schizophrenia. Structural neuroimaging studies suggest that the hippocampus, amygdala, and right insular cortex are the most critical areas implicated in ECT-related changes for these patients. Functional neuroimaging studies also highlight the involvement of the hippocampus, amygdala, and insular cortex, along with the prefrontal cortex, default mode network, and thalamostriatal system. We examine and discuss the potential implications of these incorporated findings. Given the relative scarcity of related studies, further research is needed to elucidate the mechanisms underlying the effects of ECT in patients with schizophrenia.

Electroconvulsive therapy (ECT) has been recognized as an effective treatment for schizophrenia. However, its clinical utilization has been declining due to advancements in antipsychotic medications and the persistent stigma associated with the treatment. Clinical guidelines differ in their recommendations regarding the applications of ECT in schizophrenia treatment. Existing studies demonstrated that ECT is effective for treatment-resistant schizophrenia, clozapine-resistant schizophrenia, acute psychotic exacerbations, and patients at high risk of suicide, with enhanced efficacy when combined with antipsychotic medications. Despite its clinical benefits, concerns regarding cognitive impairment, social stigma, and limited accessibility have led to its underutilization. Addressing these challenges requires expanding educational efforts for clinicians, increasing public awareness, promoting further research into its long-term efficacy and cognitive effects, and implementing policy changes to improve accessibility. This review emphasizes the essential role of ECT in schizophrenia treatment and the need to reintegrate it as a viable and necessary treatment option for suitable patients.