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Quick recovery of orientation after magnetic seizure therapy for major depressive disorder

  • George Kirov (a1), Klaus P. Ebmeier (a2), Allan I. F. Scott (a3), Maria Atkins (a4), Najeeb Khalid (a4), Lucy Carrick (a3), Andrew Stanfield (a3), Ronan E. O'Carroll (a5), Mustafa M. Husain (a6) and Sarah H. Lisanby (a7)...

Abstract

Background

Magnetic seizure therapy, in which seizures are elicited with a high-frequency magnetic field, is under development as a new treatment for major depressive disorder. Its use may be justified if it produces the antidepressant effects of electroconvulsive therapy (ECT), coupled with limited cognitive side-effects.

Aims

To evaluate the usefulness of a new 100 Hz magnetic seizure therapy device.

Method

We induced seizures with 100 Hz magnetic transcranial stimulation in 11 patients with major depressive disorder during one session of a regular course of ECT. Recovery times after seizures induced by magnetic seizure therapy and ECT were compared.

Results

Seizures could be elicited in 10 of the 11 patients. Stimulation over the vertex produced tonic-clonic activity on 9 out of 11 occasions. Stimulation over the prefrontal midpoint elicited seizures on 3 out of 7 occasions. The mean duration of magnetically induced seizures was 31.3s, ranging from 10 to 86s. All patients had an exceptionally quick recovery of orientation: mean of 7 min 12s (s.d.=2 min 7 s, range 4 min 20s to 9 min 41 s). The recovery times were on average 15 min 35s shorter with magnetic seizure therapy than with ECT in the same patients (paired-samples t-test: P<0.0001). Patients reported feeling less confused after magnetic seizure therapy. Side-effects were confined to myoclonic movements, associated with the use of etomidate.

Conclusions

The new 100Hz magnetic stimulator elicits seizures in the majority of patients when administered over the vertex. Magnetic seizure therapy was associated with shorter recovery times and less confusion following treatment. Subsequent work will be required to assess the safety and effectiveness of magnetic seizure therapy in the treatment of depression.

Copyright

Corresponding author

Professor Klaus P. Ebmeier, University of Oxford, Section of Old Age Psychiatry, Warneford Hospital, Oxford OX3 7JX, UK. Email: klaus.ebmeier@psych.ox.ac.uk

Footnotes

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Declaration of interest

None.

Funding detailed in Acknowledgements.

Footnotes

References

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1 American Psychiatric Association Task Force on Electroconvulsive Therapy. The Practice of Electroconvulsive Therapy: Recommendations for Treatment, Training, and Privileging. APA, 2001.
2 Ebmeier, KP, Donaghey, C, Steele, JD. Recent developments and current controversies in depression. Lancet 2006; 367: 153–67.
3 Eranti, SV, McLoughlin, DM. Electroconvulsive therapy - state of the art. Br J Psychiatry 2003; 182: 89.
4 Lisanby, SH, Luber, B, Finck, AD, Schroeder, C, Sackeim, HA. Deliberate seizure induction with repetitive transcranial magnetic stimulation in nonhuman primates. Arch Gen Psychiatry 2001; 58: 199200.
5 Dwork, AJ, Arango, V, Underwood, M, Ilievski, B, Rosoklija, G, Sackeim, HA, Lisanby, SH. Absence of histological lesions in primate models of ECT and magnetic seizure therapy. Am J Psychiatry 2004; 161: 576–8.
6 Lisanby, SH, Moscrip, T, Morales, O, Luber, B, Schroeder, C, Sackeim, HA. Neurophysiological characterization of magnetic seizure therapy (MST) in non-human primates. Suppl Clin Neurophysiol 2003; 56: 8199.
7 Moscrip, TD, Terrace, HS, Sackeim, HA, Lisanby, SH. Randomized controlled trial of the cognitive side-effects of magnetic seizure therapy (MST) and electroconvulsive shock (ECS). Int J Neuropsychopharmacol 2006; 9: 111.
8 Lisanby, SH, Sackeim, HA, Dwork, A, Underwood, MD, Wang, X, Kassir, SA, Luber, B, Arango, V. Effects of electroconvulsive shock and magnetic seizure therapy on mossy fiber sprouting and cellular proliferation in the primate hippocampus. Biological Psychiatry. 2003; 53: 173S.
9 Lisanby, SH, Schlaepfer, TE, Fisch, HU, Sackeim, HA. Magnetic seizure therapy of major depression. Arch Gen Psychiatry 2001; 58: 303–5.
10 Kosel, M, Frick, C, Lisanby, SH, Fisch, HU, Schlaepfer, TE. Magnetic seizure therapy improves mood in refractory major depression. Neuropsychopharmacol 2003; 28: 2045–8.
11 Lisanby, SH. Update on magnetic seizure therapy: a novel form of convulsive therapy. J ECT 2002; 18: 182–8.
12 Lisanby, SH, Luber, B, Schlaepfer, TE, Sackeim, HA. Safety and feasibility of magnetic seizure therapy (MST) in major depression: randomized within–subject comparison with electroconvulsive therapy. Neuropsychopharmacol 2003; 28: 1852–65.
13 Lisanby, SH, Husain, MM, Morales, OG, Thornton, WL, White, PF, Payne, N, Rush, AJ, Sackheim, HA. Controlled clinical trial of the antidepressant efficacy of magnetic seizure therapy in the treatment of major depression. ACNP Annu Meet Abstr 2003; p. 166.
14 White, PF, Amos, Q, Zhang, Y, Stool, L, Husain, MM, Thornton, L, Downing, M, McClintock, S, Lisanby, SH. Anesthetic considerations for magnetic seizure therapy: a novel therapy for severe depression. Anesth Analg 2006; 103: 7680.
15 Sackeim, HA, Prudic, J, Devanand, DP, Nobler, MS, Lisanby, SH, Peyser, S, Fitzsimons, L, Moody, BJ, Clark, J. A prospective, randomized, double-blind comparison of bilateral and right unilateral electroconvulsive therapy at different stimulus intensities. Arch Gen Psychiatry 2000; 57: 425–34.
16 Lisanby, SH, Peterchev, A. Magnetic seizure therapy for the treatment of depression. In Advances in Biological Psychiatry Series Volume 23: Transcranial Brain Stimulation for Treatment of Psychiatric Disorders (eds Marcolin, MA, Padberg, F): 155–71. Karger, 2007.
17 Peterchev, AV, Kirov, G, Ebmeier, K, Scott, A, Husain, M, Lisanby, SH. Frontiers in TMS technology development: controllable pulse shape TMS (cTMS) and magnetic seizure therapy (MST) at 100 Hz. Biol Psychiatry 2007; 61: S107.
18 American Psychiatric Press. Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM-IV). APA, 1994.
19 Khalid, N, Atkins, M, Kirov, G. The effects of etomidate on seizure duration and electrical stimulus dose in seizure-resistant patients during electroconvulsive therapy. J ECT 2006; 22: 184–8.
20 Folstein, MF, Folstein, SE, McHugh, PR. ‘Mini-mental state’: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189–98.
21 Scott, AIF. The ECT Handbook. Royal College of Psychiatrists, 2005.
22 Sobin, C, Sackeim, HA, Prudic, J, Devanand, DP, Moody, BJ, McElhiney, MC. Predictors of retrograde amnesia following ECT. Am J Psychiatry 1995; 152: 9951001.

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Quick recovery of orientation after magnetic seizure therapy for major depressive disorder

  • George Kirov (a1), Klaus P. Ebmeier (a2), Allan I. F. Scott (a3), Maria Atkins (a4), Najeeb Khalid (a4), Lucy Carrick (a3), Andrew Stanfield (a3), Ronan E. O'Carroll (a5), Mustafa M. Husain (a6) and Sarah H. Lisanby (a7)...
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