Skip to main content Accessibility help
×
Home

Electroconvulsive therapy versus transcranial magnetic stimulation for major depression: a review with recommendations for future research

  • Keith G. Rasmussen (a1)

Abstract

Objective:

To review the literature comparing electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) for major depression.

Methods:

Data from the six randomised, prospective studies were agglutinated into one data set. Special attention was given to the methods of both TMS and ECT as well as data pertaining to differential outcomes in subgroups such as psychotic depressives and the elderly.

Results:

There is a highly significant advantage for ECT in the prospective, randomised trials. The two non-randomised, retrospective comparative trials found the treatments to be equal in one study and superior for ECT in another. However, sample sizes are small in these studies, and both TMS and ECT may have been used suboptimally. Furthermore, the possibilities of differential efficacy of ECT or TMS for psychotic depressives or as a function of age have yet to be fully explored.

Conclusions:

The data to date do not support the contention that TMS is equivalent in efficacy to ECT. It is recommended that a large-scale trial be undertaken using aggressive forms of both TMS and ECT with sample sizes sufficiently large to detect effects of moderating variables such as age and psychosis status.

Copyright

Corresponding author

Keith G. Rasmussen, Mayo Clinic Department of Psychiatry and Psychology, 200 First Street SW, Rochester, Minnesota 55905, USA. Tel: 507-284-3789; Fax: 507-284-4158; E-mail: rasmussen.keith@mayo.edu

References

Hide All
1.Burt, T, Lisanby, SH, Sackeim, HA. Neuropsychiatric applications of transcranial magnetic stimulation: a meta-analysis. Int J Neuropsychopharmacol 2002;5:73103.
2.Pridmore, S, Bruno, R, Turnier-Shea, Y, Reid, P, Rybak, M. Comparison of unlimited numbers of rapid transcranial magnetic stimulation (rTMS) and ECT treatment sessions in major depressive episode. Int J Neuropsychopharmacol 2000;3:129134.
3.Grunhaus, L, Dannon, PN, Schreiber, S, Dolberg, OH, Amiaz, R, Lefkifker, E. Repetitive transcranial magnetic stimulation is as effective as electroconvulsive therapy in the treatment of nondelusional major depressive disorder: an open study. Biol Psychiatry 2000;47:314324.
4.Janicak, PG, Dowd, SM, Martis, Bet al. Repetitive transcranial magnetic stimulation versus electroconvulsive therapy for major depression: preliminary results of a randomized trial. Biol Psychiatry 2002;51:659667.
5.Dannon, PN, Dolberg, OT, Schreiber, S, Grunhaus, L. Three and six-month outcome following courses of either ECT or rTMS in a population of severely depressed individuals – preliminary report. Biol Psychiatry 2002;51:687690.
6.Grunhaus, L, Schreiber, S, Dolberg, OT, Polak, D, Dannon, PN. A randomized controlled comparison of electroconvulsive therapy and repetitive transcranial magnetic stimulation in severe and resistant nonpsychotic major depression. Biol Psychiatry 2003;53:324331.
7.O’Connor, M, Brenninkmeyer, C, Morgan, Aet al. Relative effects of repetitive transcranial magnetic stimulation and electroconvulsive therapy on mood and memory: a neurocognitive risk-benefit analysis. Cogn Behav Neurol 2003;16:118127.
8.Schulze-Rauschenbach, SC, Harms, U, Schlaepfer, TE, Maier, W, Falkai, P, Wagner, M. Distinctive neurocognitive effects of repetitive transcranial magnetic stimulation and electroconvulsive therapy in major depression. Br J Psychiatry 2005;186:410416.
9.Rosa, MA, Gattaz, WF, Pascual-Leone, Aet al. Comparison of repetitive transcranial magnetic stimulation and electroconvulsive therapy in unipolar non-psychotic refractory depression: a randomized, single-blind study. Int J Neuropsychopharmacol 2006;9:667676.
10.Eranti, S, Mogg, A, Pluck, Get al. A randomized, controlled trial with 6-month follow up of repetitive transcranial magnetic stimulation and electroconvulsive therapy for severe depression. Am J Psychiatry 2007;164:7381.
11.O’Reardon, JP, Solvason, HB, Janicak, PGet al. Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial. Biol Psychiatry 2007;62:12081216.
12.Petrides, G, Fink, M, Husain, MMet al. ECT remission rates in psychotic versus nonpsychotic depressed patients: a report from CORE. J ECT 2001;17:244253.
13.O’Connor, MK, Knapp, R, Husain, Met al. The influence of age on the response of major depression to electroconvulsive therapy: a C.O.R.E. report. Am J Geriatr Psychiatry 2001;9:382390.
14.Abrams, R. Electroconvulsive therapy, 4th edn. New York: Oxford University Press, 2002.
15.Janicak, PG, Dowd, S, Rado, Jet al. Repetitive transcranial magnetic stimulation versus electroconvulsive therapy: efficacy of treatment in nonpsychotic patients with depression (letter). Am J Psychiatry 2007;164:1118.

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed