Advertisement

Three and six-month outcome following courses of either ECT or rTMS in a population of severely depressed individuals—preliminary report

      Abstract

      Background: Recent studies have strengthened the claim that repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for major depression. The longitudinal outcome of TMS-treated patients, however, has not been described. We report on the 3- and 6-month outcomes of a group of patients treated with either electroconvulsive therapy (ECT) (n = 20) or (rTMS) (n = 21).
      Methods: Patients diagnosed with major depressive disorder with or without psychotic features referred for ECT were randomly assigned to receive either ECT or rTMS. Forty-one patients who responded to either treatment constituted the sample. Patients were followed on a monthly basis and outcomes were determined with the Hamilton Rating Scale for Depression-17 items (HRSD) and the Global Assessment of Functioning (GAF) scales. Medications were routinely prescribed.
      Results: There were no differences in the 6-month relapse rate between the groups. Overall, 20% of the patients relapsed (four from the ECT group and four from the rTMS group). Patients reported equally low and not significantly different scores in the HRSD (ECT group 8.4 ± 5.6 and TMS group 7.9 ± 7.1) and the GAF (ECT group 72.8 ± 12 and TMS group 77.8 ± 17.1) at the 6-month follow up.
      Conclusions: Patients treated with rTMS do as well as those treated with ECT at the 3- and 6-month follow-up points. These data suggest that the clinical gains obtained with rTMS last at least as long as those obtained with ECT.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Biological Psychiatry
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • American Psychiatric Association
        The practice of ECT.
        Task force report on ECT. American Psychiatric Association, Washington DC1990
        • Barker A.T
        An introduction to the basic principles of magnetic nerve stimulation.
        J Clin Physiology. 1991; 8: 26-37
        • Barker A.T
        • Jalinous R
        • Freeton H
        • Jarratt J.A
        Motor responses to noninvasive brain stimulation in clinical practice.
        Electroenceph Clin Neurophysiol. 1985; 61: 570-574
        • Dannon P.N
        • Schreiber S
        • Dolberg O.T
        • Shemer L
        • Grunhaus L
        Transcranial Magnetic Stimulation is effective as the first time in the treatment of relapse of Major Depressive Disorder.
        Int Clin Psychiatry. 2000; 4: 223-226
        • Flint A.J
        • Rifat S.L
        Two-year outcome of psychotic depression in late life.
        Am J Psychiatry. 1998; 155: 178-183
        • Folkerts H.W
        • Michael N
        • Tolle R
        • et al.
        ECT vs. paroxetine in the treatment resistant depression.
        Acta Psych Scand. 1997; 96: 334-342
        • George M.S
        • Nahas Z
        • Molloy M
        • et al.
        A controlled trial of daily left prefrontal cortex TMS for treatment of depression.
        Biol Psychiatry. 2000; 48: 962-970
        • Grunhaus L
        • Dannon P.N
        • Schreiber S
        • et al.
        rTMS appears to be as effective as ECT in the treatment of non-delusional MDD—an open study.
        Biol Psychiatry. 2000; 47: 314-324
        • Grunhaus L
        • Dolberg O
        • Lustig M
        Relapse and recurrence following a course of ECT.
        J Psychiatr Res. 1995; 29: 165-172
        • Grunhaus L
        • Remen A
        Assessment of treatment resistant major depression—the Michigan Adequacy of treatment scale.
        J Clin Psychopharm. 1993; 3: 221-223
        • Loo C
        • Mitchell P
        • Sachdev P
        • et al.
        Double blind controlled investigation of TMS for the treatment of resistant MDD.
        Am J Psychiatry. 1999; 156: 946-948
        • Pridmore S
        Substitution of rTMS treatment for ECT treatment in the course of ECT.
        Depress Anxiety. 2000; 12: 118-123
        • Sackeim H.A
        • Decina P
        • Pornoy P.J
        • et al.
        Studies of dosage, seizure threshold and seizure duration in ECT.
        Biol Psychiatry. 1987; 22: 249-268
        • Sackeim H.A
        • Haskett R.F
        • Benoit H
        • et al.
        Continuation pharmacotherapy in the prevention of relapse following ECT.
        JAMA. 2001; 285: 1299-1307
        • Wassermann E
        • et al.
        Crossed reduction of human motor cortex excitability by 1-hz TMS.
        Neurosci Lett. 1998; 250: 141-144