S194. CLOZAPINE AND ELECTROCONVULSIVE THERAPY AUGMENTATION IN ADOLESCENTS WITH TREATMENT-RESISTANT SCHIZOPHRENIA

BACKGROUND: Early onset schizophrenia is associated unfavorable treatment response and psychosocial outcome. Clozapine or Electroconvulsive Therapy (ECT) have suggested that these therapies may have an important role in treatment in treatment resistant schizophrenia in adolescents. The aim of this study was to compare effectiveness between clozapine and ECT augmentation in adolescents with treatment-resistant schizophrenia. METHODS: We retrospectively reviewed the electronic medical records of 27 adolescents with treatment-resistant schizophrenia (age 15.6±1.4 years; 16 boys, 59.3%) who were treated with clozapine or clozapine plus ECT. Effectiveness was measured with the Clinical Global Impressions–Severity (CGI-S) and/or Clinical Global Impressions–Improvement (CGI-I) scales at baseline, and after 2, 4 and 8 weeks. Treatment response was defined as a CGI-S < 3 or CGI-I < 3. RESULTS: The 21 adolescents treated with clozapine alone (age 15.5±1.2 years; 14 boys, 66.7%), and six adolescents treated with clozapine plus ECT (age 16.0±2.1 years; 2 boys, 33.3%) were compared their treatment effectiveness. The 13 adolescents (61.0%) in clozapine alone group and four adolescents (66.7%) in clozapine plus ECT group met the treatment response criterion. Three (50.0%) of adolescents with clozapine plus ECT group experienced mild post ictal confusion and two (9.5%) of adolescents with clozapine alone group experienced mild reduction of WBC and ANC. DISCUSSION: Our results suggest that clozapine and ECT augmentation could be one of safe and effective treatment in adolescents with treatment-resistant schizophrenia.