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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, Savitha, Mogg, Andrew, Pluck, Graham, Landau, Sabine, Purvis, Rick, Brown, Richard G., Howard, Robert, Knapp, Martin, Philpot, Michael, Rabe-Hesketh, Sophia, Romeo, Renee, Rothwell, John, Edwards, Denzil and McLoughlin, Declan M. (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). pp. 73-81. ISSN 0002-953X

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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.

Item Type: Article
Official URL: http://ajp.psychiatryonline.org/
Additional Information: © 2007 American Psychiatric Association
Library of Congress subject classification: R Medicine > RZ Other systems of medicine
Sets: Departments > Social Policy
Research centres and groups > Personal Social Services Research Unit (PSSRU)
Research centres and groups > BIOS (Centre for the Study of Bioscience, Biomedicine, Biotechnology and Society)
Rights: http://www.lse.ac.uk/library/usingTheLibrary/academicSupport/OA/depositYourResearch.aspx
Date Deposited: 08 Feb 2008
URL: http://eprints.lse.ac.uk/3303/

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