Eleven studies (n=651) were included in the review. Eight trials were RCTs (n=343) and three were open trials (n=308).
Four studies (n=113) were of sufficient methodological quality to be included in the meta-analysis. Treatment with the ECT-antipsychotic combination resulted in a statistically significant decrease in Brief Psychiatric Rating Scale score in the first four to five weeks of treatment (mean difference was 4.89, 95% CI:0.50 to 9.38, p<0.05).
Heterogeneity was observed to be statistically significant among studies (Χ2=8.48, p<0.05). This became non-significant when one study that had not reported baseline Brief Psychiatric Rating Scale scores was removed from the analysis.
Results of the narrative synthesis suggested that the ECT-antipsychotic combination was more effective than antipsychotic drugs alone for just the first three to six weeks of treatment.