Antidepressant effects, of magnetic seizure therapy and electroconvulsive therapy, in treatment-resistant depression

Sarah Kayser, Bettina H. Bewernick, Christiane Grubert, Barbara L. Hadrysiewicz, Nikolai Axmacher, Thomas E. Schlaepfer

Research output: Contribution to journalArticlepeer-review

Abstract

Major depression is a common mental health problem and associated with significant morbidity and mortality, including impaired social and physical functioning and increased risk for suicide. Electroconvulsive therapy (ECT) is highly efficacious in treatment-resistant depressive disorders, but cognitive side effects are frequently associated with the treatment. Magnetic seizure therapy (MST) is a form of convulsive therapy, using magnetic fields in order to induce therapeutic seizures. First studies suggested that cognitive side effects of MST, including postictal recovery time, are more benign than those resulting from ECT treatment. In this open-label study we tested the hypothesis that MST is associated with clinically significant antidepressant effects in treatment-resistant depression (TRD) as an add-on therapy to a controlled pharmacotherapy.Twenty patients suffering from TRD were randomly assigned to receive either MST or ECT starting from July 2006 until November 2008. Primary outcome measure was antidepressant response assessed by Montgomery Åsberg Depression Scale. Secondary outcome measures included Hamilton Depression Rating Scale, Hamilton Anxiety Scale, Beck Depression Inventory and 90-Item Symptom Checklist.Antidepressant response (improvement of 50% in MADRS ratings) was statistically significant and of similar size in both treatment groups. Cognitive side effects were observed in neither group. Characteristics in MST- and ECT-induced seizures were comparable, especially regarding ictal activity and postictal suppression. Thus, MST may be a potential alternative to ECT if efficacy and safety are validated in larger clinical trials.

Original languageEnglish (US)
Pages (from-to)569-576
Number of pages8
JournalJournal of Psychiatric Research
Volume45
Issue number5
DOIs
StatePublished - May 2011

Keywords

  • Electroconvulsive therapy (ECT)
  • Magnetic seizure therapy (MST)
  • Treatment-resistant depression (TRD)

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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