Comparison of repetitive transcranial magnetic stimulation and electroconvulsive therapy in unipolar non-psychotic refractory depression: a randomized, single-blind study

Repetitive transcranial magnetic stimulation (rTMS) can induce significant antidepressant effects and, for some patients, might be an alternative to electroconvulsive therapy (ECT). The results of studies comparing the efficacy of rTMS and ECT are mixed and, therefore, comparison of these two therap...

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Bibliographic Details
Published in:The international journal of neuropsychopharmacology 2006-12, Vol.9 (6), p.667-676
Main Authors: Rosa, Moacyr Alexandro, Gattaz, Wagner Farid, Pascual-Leone, Alvaro, Fregni, Felipe, Rosa, Marina Odebrecht, Rumi, Demetrio Ortega, Myczkowski, Martin, Silva, Maria Fernanda, Mansur, Carlos, Rigonatti, Sergio Paulo, Jacobsen Teixeira, Manuel, Marcolin, Marco Antonio
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Cognition - physiology
Depressive Disorder - psychology
Depressive Disorder - therapy
Electroconvulsive Therapy
Female
Humans
Male
Middle Aged
Neuropsychological Tests
Psychiatric Status Rating Scales
Recurrence
Risk
Single-Blind Method
Transcranial Magnetic Stimulation
Treatment Outcome
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Summary:Repetitive transcranial magnetic stimulation (rTMS) can induce significant antidepressant effects and, for some patients, might be an alternative to electroconvulsive therapy (ECT). The results of studies comparing the efficacy of rTMS and ECT are mixed and, therefore, comparison of these two therapies needs to be further explored. Forty-two patients aged between 18 and 65 yr, referred to ECT due to unipolar non-psychotic depression refractoriness entered the trial. They were randomly assigned to receive either rTMS or ECT. Depressive symptom changes were blindly measured by Hamilton Depression Rating Scale, Visual Analogue Scale and Clinical Global Impression at baseline, after 2 wk and after 4 wk of treatment. There was no difference in the antidepressant efficacy of ECT and rTMS. Response rates were relatively low in both groups (40% and 50% respectively), with no significant difference between them (p=0.55). Remission rates were also low for both groups (20% and 10% respectively), also with no significant difference (p=0.631). There was no significant difference in the neuropsychological test performance after either one of these therapies. Both treatments were associated with a degree of improvement in refractory depression and therefore add to the literature that rTMS can be an effective option to ECT as it is a less costly treatment and is not associated with anaesthetic and other ECT risks.
ISSN:1461-1457
1469-5111
DOI:10.1017/S1461145706007127