ECT in Ultra-resistant Schizophrenia

Inclusion Criteria:

• Patients with URS: patients who continue to experience persistent positive psychoticsymptoms: item score of 4 (moderate) on at least two of four positive symptoms on theBPRS (grandiosity, suspiciousness, hallucinations and unusual thoughts), currentpresence of at least moderately severe illness on the total BPRS-18 (45) and a scoreof 4 (moderate) on the CGI-S, despite a period of clozapine therapy of at least 6weeks with a plasma concentration of 350 ng/ml and at least two unsuccessful previoustreatment trials with conventional or atypical antipsychotic drugs from two distinctfamilies at a dose 600 mg of chlorpromazine equivalents.

• Age: from 18 to 55

• Patients with stable treatments for at least 8 weeks (antipsychotics, mood stabilizersand antidepressants).

• Participants who gave their informed, written consents and agreement of their guardianfor the patients under guardianship

• Patients deprived of liberty if they gave their informed, written consents

Exclusion Criteria:

• Current affective episode according to DSM-5 criteria;

• ECT within (the last) 6 months;

• Unstable epilepsy ; severe neurological or systemic disorder that could significantlyaffect cognition, behavior, or mental status (other than late dyskinesia orneuroleptic-induced parkinsonism);

• Severe substance use disorders (other than nicotine or caffeine) according to DSM-5criteria.

• Concomitant use of antiepileptics and benzodiazepines apart from lamotrigine

• Women of childbearing age with no adequate contraception, pregnant or lactating women;

• Patients having contraindications to etomidate or any of its excipients;

• Patients having contraindications to neuromuscular blocking agents;

• Patients participating or having participated in an interventional clinical trialwithin 30 days prior to the inclusion visit;