Tests maintenance electroconvulsive therapy in clozapine-resistant schizophrenia after successful treatment
Tests repeated electroconvulsive therapy to prevent relapse in adults with schizophrenia not helped by clozapine.
Plain-language title generated from the registry record
Registry title: Maintenance ElectroConvulsive Therapy in Clozapine RESISTant Schizophrenia - the MECT-RESIST Trial
Key facts
- Where
- Aachen, Augsburg, Göppingen, Göttingen, Hanover, Heidelberg, Ingolstadt, Mainz, Mannheim, München, Saarbrücken, Siegen, Tübingen, and Wiesloch, GermanySee the 14 sites
Could this be for you?
Answer for yourself. This is not a decision: only the study team can say whether you can take part.
- Are you between 18 and 75 years old?
Source: NCT06456983, who can take part
Where in Germany
- Dept. of Psychiatry, RWTU AachenAachen, GermanyNot yet recruiting
- Dept. of Psychiatry, University of AugsburgAugsburg, GermanyNot yet recruiting
- Klinik für Psychiatrie, GöppingenGöppingen, GermanyNot yet recruiting
- Departmet of Psychiatry, University Medical Center GöttingenGöttingen, GermanyNot yet recruiting
- Dept. of Psychiatry, Hannover Medical SchoolHanover, GermanyNot yet recruiting
- Universitätsklinikum Heidelberg, Klinik für Allgemeine PsychiatrieHeidelberg, GermanyNot yet recruiting
- Zentrum für Psychische GesundheitIngolstadt, GermanyNot yet recruiting
- Dept. of Psychiatry, University MainzMainz, GermanyNot yet recruiting
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health (CIMH)Mannheim, GermanyTaking people
- Dept. of Psychiatry, LMU MünchenMünchen, GermanyNot yet recruiting
- Clinic for Psychiatry, SaarbrückenSaarbrücken, GermanyNot yet recruiting
- Klinik für Psychiatrie, SiegenSiegen, GermanyNot yet recruiting
- Dept. of Psychiatry, University TübingenTübingen, GermanyNot yet recruiting
- Dept. of Psychiatry I, WieslochWiesloch, GermanyNot yet recruiting
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Central Institute of Mental Health, Mannheim
- Trial code
- NCT06456983
- Record updated
- 3 February 2026
- Original description
Schizophrenia is one of the most severe and costliest mental disorders in terms of human suffering and societal expenditure. About 15-30% of patients do not respond to all known antipsychotics, including clozapine, the current gold-standard in these cases. Hence, a recent Cochrane review stated that the quality of the existing studies is too poor to recommend any intervention in addition to clozapine and that new, randomized controlled trials independent from the pharmaceutical industry need to be performed to substantially improve patient care. Although electroconvulsive therapy (ECT) was initially used to treat schizophrenia, it is nowadays by far underused in the therapy of schizophrenia in many countries. ECT is well known to be highly effective in clozapine-treatment-resistant schizophrenia (CRS), and synergistic effects of clozapine and ECT have been demonstrated. However, relapse rates after successful courses of ECT are still very high, and evidence for maintenance ECT (mECT) in CRS is scarce at best. In a multi-center trial the investigators aim to examine the effectiveness of mECT in treatment-resistant patients with schizophrenia who improved after a course of routine ECT. If mECT will lead to a later timepoint of relapse and/or to a higher proportion of relapse-free patients compared to those undergoing treatment as usual, this trial would have an enormous impact on therapeutic strategies for "treatment-resistant" patients and would induce a profound change of current treatment guidelines, where ECT still ranks at the level of ultima ratio, despite accumulating evidence suggesting otherwise.Read full original descriptionShow less
Maintenance ElectroConvulsive Therapy in Clozapine RESISTant Schizophrenia - the MECT-RESIST Trial
Schizophrenia is one of the most severe and costliest mental disorders in terms of human suffering and societal expenditure. About 15-30% of patients do not respond to all known antipsychotics, including clozapine, the current gold-standard in these cases. Hence, a recent Cochrane review stated that the quality of the existing studies is too poor to recommend any intervention in addition to clozapine and that new, randomized controlled trials independent from the pharmaceutical industry need to be performed to substantially improve patient care. Although electroconvulsive therapy (ECT) was initially used to treat schizophrenia, it is nowadays by far underused in the therapy of schizophrenia in many countries. ECT is well known to be highly effective in clozapine-treatment-resistant schizophrenia (CRS), and synergistic effects of clozapine and ECT have been demonstrated. However, relapse rates after successful courses of ECT are still very high, and evidence for maintenance ECT (mECT) in CRS is scarce at best. In a multi-center trial the investigators aim to examine the effectiveness of mECT in treatment-resistant patients with schizophrenia who improved after a course of routine ECT. If mECT will lead to a later timepoint of relapse and/or to a higher proportion of relapse-free patients compared to those undergoing treatment as usual, this trial would have an enormous impact on therapeutic strategies for "treatment-resistant" patients and would induce a profound change of current treatment guidelines, where ECT still ranks at the level of ultima ratio, despite accumulating evidence suggesting otherwise.
Inclusion: Current schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), BPRS total score > 45 and history of clozapine resistant schizophrenia (CRS), which will include treatment-resistant schizophrenia with clozapine intolerance or absolute contraindications for clozapine.
Exclusion: Diagnosis of DSM-5 major neurocognitive disorder ("dementia"), current severe substance-use disorder, affective disorders with psychotic symptoms or any personality disorder; General medical condition contraindicating ECT; Inability to read/write German; Pregnancy or breast-feeding.