Effects of modified electroconvulsive therapy on intracranial pressure in psychotic patients with schizophrenia

Modified electroconvulsive therapy (MECT) is an effective treatment option for schizophrenia, however, concerns on its safety and complications such as increased intracranial pressure (ICP) exists. The purpose of this study was to assess the effects of MECT on ICP in schizophrenic patients and to identify related risk factors. 112 subjects diagnosed with schizophrenia were recruited and allocated into the MECT treatment group and the casecontrol group without MECT treatment. Results showed that in the case control group, females had significantly higher ICP than males (P<0.05). In the MECT treatment group, those experiencing normal seizure had similar ICP before and after MECT treatment (P>0.05), suggesting that the MECT treatment did not affect ICP. The right side ICP after 8 MECT in the normal seizure group was significantly higher than the health control group (P<0.05). The left side ICP after the first MECT in the prolonged seizure group was significantly higher than the health control group (P<0.05). The left side ICP and the average ICP in the prolonged seizure group after the first MECT, fourth and eighth MECT were significantly higher before the treatment (P<0.05). The incidence rate of increased intracranial pressure (ICP>200 mmH2O) of the normal seizure group and the prolonged seizure group were 8% and 14.3%. In summary, the ICP of psychiatric patients may have gender differences. MECT may probably increase the ICP of psychiatric patients, especially the prolonged seizure patients.