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A randomized, controlled trial with 6-month follow-up of repetitive transcranial magnetic stimulation and electroconvulsive therapy for severe depression

Eranti, S; Mogg, A; Pluck, G; Landau, S; Purvis, R; Brown, RG; Howard, R; ... McLoughlin, DM; + view all (2007) A randomized, controlled trial with 6-month follow-up of repetitive transcranial magnetic stimulation and electroconvulsive therapy for severe depression. AMERICAN JOURNAL OF PSYCHIATRY , 164 (1) 73 - 81.

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Abstract

Objective: Repetitive transcranial magnetic stimulation ( rTMS) has been reported to be as effective as electroconvulsive therapy ( ECT) for major depression. The authors conducted a multicenter randomized, controlled trial to test the equivalence of rTMS with ECT.Method: Forty-six patients with major depression referred for ECT were randomly assigned to either a 15-day course of rTMS of the left dorsolateral prefrontal cortex ( N=24) or a standard course of ECT ( N=22). The primary outcome measures were the score on the 17-item Hamilton Depression Rating Scale ( HAM-D) and the proportion of patients with remissions ( Hamilton score, <= 8) at the end of treatment. Secondary outcomes included mood self-ratings on the Beck Depression Inventory-II and visual analogue mood scales, Brief Psychiatric Rating Scale ( BPRS) score, and both self-reported and observer-rated cognitive changes. The patients were followed up after 6 months.Results: HAM-D scores at the end of treatment were significantly lower for ECT, with 13 patients ( 59.1%) achieving remission in the ECT group and four ( 16.7%) in the rTMS group. However, at 6 months the HAM- D scores did not differ between groups. Beck scale, visual analogue mood scale, and BPRS scores were lower for ECT at the end of treatment and remained lower after 6 months. Self- and observer-rated cognitive measures were similar in the two groups.Conclusions: rTMS was not as effective as ECT, and ECT was substantially more effective for the short-term treatment of depression.

Type: Article
Title: A randomized, controlled trial with 6-month follow-up of repetitive transcranial magnetic stimulation and electroconvulsive therapy for severe depression
Location: Atlanta, GA
Keywords: MAJOR DEPRESSION, MOTOR THRESHOLD, RATING-SCALE, ECT, EFFICACY, METAANALYSIS, MEMORY, RTMS
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Movement Neurosciences
URI: http://discovery.ucl.ac.uk/id/eprint/153259
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