Date of Award


Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)


Physician Assistant Studies

First Advisor

Daryl Sieg


Electroconvulsive therapy; Schizophrenia


Schizophrenia is a complicated problem that millions of Americans struggle with and unfortunately, about 50 percent of schizophrenics become resistant to medication. It is common practice to try multiple drugs to combat this resistance and many patients are placed on clozapine or given electroconvulsive therapy (ECT) as a last resort. Research has shown that many are not receiving the benefits of these treatments due to adverse effects, negative public opinion, and difficulty executing high quality research studies particularly when it comes to ECT. As a result, a significant number of patients that would benefit from these interventions are suffering with uncontrolled schizophrenia. More data is required on the use of these interventions as much of the research is low quality due to the unpredictable nature of schizophrenia and many patients not completing trials. This study analyzed the literature available for the efficacy and safety of both clozapine and ECT in order to understand its benefit versus risk in refractory schizophrenics. After analyzing the quality and results of many peer-reviewed studies, it was found that ECT and clozapine are both effective and safe for patients. Clozapine was shown to have more serious and long-term side effects than ECT, but both were shown to be effective. ECT was also shown to be effective for patients that were refractory to clozapine. Finally, the data showed combined therapy to be the most effective and I can conclude that it should be used far more often than is currently reported.