TY - JOUR
T1 - Repetitive transcranial magnetic stimulation is as effective as electroconvulsive therapy in the treatment of nondelusional major depressive disorder
T2 - An open study
AU - Grunhaus, Leon
AU - Dannon, Pinhas N.
AU - Schreiber, Shaul
AU - Dolberg, Ornah H.
AU - Amiaz, Revital
AU - Ziv, Reuven
AU - Lefkifker, Eli
N1 - Funding Information:
This study was made possible by an Established Investigator Award of NARSAD to Leon Grunhaus, MD. Elisheba Noy and Lital Shemer were in charge of the data collection and data analysis. Their diligent work was invaluable to the success of this study. Partial results from this study were presented at the 1998 Biological Psychiatry Meeting in Toronto.
PY - 2000/2/15
Y1 - 2000/2/15
N2 - Background: Repetitive transcranial magnetic stimulation (rTMS), a new method for the stimulation of the central nervous system, is being proposed as a potential new treatment in patients with major depressive disorder (MDD). We tested the hypothesis that rTMS would be as effective as electroconvulsive therapy (ECT) in patients with MDD. Methods: Forty patients with MDD referred for ECT were randomly assigned to either ECT or rTMS. Repetitive transcranial magnetic stimulation was performed at 90% power of the motor threshold. The stimulation frequency was 10 Hz for either 2 sec (first eight patients) or 6 sec (final 12 patients) for 20 trains. Patients were treated for up to 20 treatment days. Electroconvulsive therapy was performed according to standard protocols. Results: Overall patients responded best to ECT (χ2 = 3.8, p < .05). Patients with MDD and psychosis responded significantly better to ECT (χ2 = 9.2, p < .01), whereas MDD patients without psychosis responded similarly to both treatments (χ2 = 0.0, ns). The analysis of variance with repeated measures of clinical variables for the whole sample revealed significant treatment effects for both groups; however, interaction between group and treatment was seen only for the Global Assessment of Function and the Sleep assessment. When the psychosis-nonpsychosis grouping was considered, patients with psychosis responded dramatically better to ECT in all assessments, whereas those without psychosis responded similarly to both treatments. Conclusions: Overall ECT was a more potent treatment for patients with MDD, this being particularly evident in patients with MDD and psychosis; however, in patients with MDD without psychosis the effects of rTMS were similar to those of ECT. The results we report are encouraging and support an important role for rTMS in the treatment of severe MDD; however, additional blinded studies are needed to precisely define this role. (C) 2000 Society of Biological Psychiatry.
AB - Background: Repetitive transcranial magnetic stimulation (rTMS), a new method for the stimulation of the central nervous system, is being proposed as a potential new treatment in patients with major depressive disorder (MDD). We tested the hypothesis that rTMS would be as effective as electroconvulsive therapy (ECT) in patients with MDD. Methods: Forty patients with MDD referred for ECT were randomly assigned to either ECT or rTMS. Repetitive transcranial magnetic stimulation was performed at 90% power of the motor threshold. The stimulation frequency was 10 Hz for either 2 sec (first eight patients) or 6 sec (final 12 patients) for 20 trains. Patients were treated for up to 20 treatment days. Electroconvulsive therapy was performed according to standard protocols. Results: Overall patients responded best to ECT (χ2 = 3.8, p < .05). Patients with MDD and psychosis responded significantly better to ECT (χ2 = 9.2, p < .01), whereas MDD patients without psychosis responded similarly to both treatments (χ2 = 0.0, ns). The analysis of variance with repeated measures of clinical variables for the whole sample revealed significant treatment effects for both groups; however, interaction between group and treatment was seen only for the Global Assessment of Function and the Sleep assessment. When the psychosis-nonpsychosis grouping was considered, patients with psychosis responded dramatically better to ECT in all assessments, whereas those without psychosis responded similarly to both treatments. Conclusions: Overall ECT was a more potent treatment for patients with MDD, this being particularly evident in patients with MDD and psychosis; however, in patients with MDD without psychosis the effects of rTMS were similar to those of ECT. The results we report are encouraging and support an important role for rTMS in the treatment of severe MDD; however, additional blinded studies are needed to precisely define this role. (C) 2000 Society of Biological Psychiatry.
KW - ECT
KW - Electroconvulsive therapy
KW - MDD
KW - TMS
KW - Transcranial magnetic stimulation
UR - http://www.scopus.com/inward/record.url?scp=0033964404&partnerID=8YFLogxK
U2 - 10.1016/S0006-3223(99)00254-1
DO - 10.1016/S0006-3223(99)00254-1
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C2 - 10686266
AN - SCOPUS:0033964404
SN - 0006-3223
VL - 47
SP - 314
EP - 324
JO - Biological Psychiatry
JF - Biological Psychiatry
IS - 4
ER -