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Volume 51, Issue 8, Pages 659-667 (15 April 2002)


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Repetitive transcranial magnetic stimulation versus electroconvulsive therapy for major depression: preliminary results of a randomized trial

Philip G JanicakCorresponding Author Informationa, Sheila M Dowda, Brian Martisa, Danesh Alama, Dennis Beedlea, Jack Krasuskia, Mary Jane Stronga, Rajiv Sharmaa, Cherise Rosena, Marlos Vianaa

Received 30 July 2001; received in revised form 12 November 2001; accepted 21 November 2001.

Abstract 

Background: Many severely depressed patients do not benefit from or tolerate existing treatments. Repetitive transcranial magnetic stimulation (rTMS) has been reported to benefit depression. We compared rTMS to electroconvulsive therapy (ECT) in severely ill, depressed patients.

Methods: Twenty-five patients with a major depression (unipolar or bipolar) deemed clinically appropriate for ECT were randomly assigned to rTMS (10–20 treatments, 10 Hz, 110% motor threshold applied to the left dorsolateral prefrontal cortex for a total of 10,000–20,000 stimulations) or a course of bitemporal ECT (4–12 treatments). The primary outcome measure was the 24-item Hamilton Depression Rating Scale (HDRS). The Brief Psychiatric Rating Scale (BPRS), Young Mania Rating Scale (YMS), and Clinical Global Impression scale (CGI) were secondary measures. Minimal rescue medications were utilized.

Results: Mean percent improvement on the baseline HDRS score did not significantly differ between the two treatments (i.e., 55% for the rTMS group vs. 64% for the ECT group [p = ns]). With response defined as a 50% reduction from baseline and a final score ≤ 8 on the HDRS, there was also no significant difference between the two groups. We did not observe any differences between groups on the secondary measures.

Conclusions: A 2–4 week randomized, prospective trial comparing rTMS to ECT produced comparable therapeutic effects in severely depressed patients.

a Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois, USA

Corresponding Author InformationAddress reprint requests to Philip G. Janicak, M.D., University of Illinois at Chicago, Department of Psychiatry, 1601 W. Taylor Street, Chicago IL 60612 USA

PII: S0006-3223(01)01354-3


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