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Randomized Controlled Trial
. 2007 Jan;164(1):73-81.
doi: 10.1176/ajp.2007.164.1.73.

A randomized, controlled trial with 6-month follow-up of repetitive transcranial magnetic stimulation and electroconvulsive therapy for severe depression

Savitha Eranti  1 , Andrew Mogg, Graham Pluck, Sabine Landau, Rick Purvis, Richard G Brown, Robert Howard, Martin Knapp, Michael Philpot, Sophia Rabe-Hesketh, Renee Romeo, John Rothwell, Denzil Edwards, Declan M McLoughlin
Affiliations
Randomized Controlled Trial

A randomized, controlled trial with 6-month follow-up of repetitive transcranial magnetic stimulation and electroconvulsive therapy for severe depression

Savitha Eranti et al. Am J Psychiatry. 2007 Jan.

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, <or=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.

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