Electroconvulsive therapy (ECT) is an effective strategy in some treatment-resistant patients with
schizophrenia. However, ECT is associated with cognitive adverse effects, most notably,
memory loss. This study examined the effects of
rivastigmine, a selective central nervous system
acetylcholinesterase inhibitor, with benefits on cognition in
Alzheimer disease, on memory performance in patients with
schizophrenia treated with ECT. Thirty inpatients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision
schizophrenia treated with ECT were coadministered
rivastigmine (3-4.5 mg/d) or placebo in a prospective, randomized, double-blind, placebo-controlled trial (maximum period of 4 weeks). Over the ECT course, scores on the cognitive subscale of the
Alzheimer's Disease Assessment in subjects receiving placebo showed no significant change, whereas subjects receiving
rivastigmine displayed decreased cognitive subscale of the
Alzheimer's Disease Assessment scores, indicating cognitive improvement (P < 0.05). Findings suggest possible involvement of the acetylcholinergic system in mediation of cognitive deficits after ECT and indicate possible beneficial effects of
rivastigmine coadministration in minimizing some of these ECT-induced
cognitive impairments.