Three and six-month outcome following courses of either ECT or rTMS in a population of severely depressed individuals--preliminary report.
BACKGROUND
Recent studies have strengthened the claim that repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for major depression. The longitudinal outcome of TMS-treated patients, however, has not been described. We report on the 3- and 6-month outcomes of a group of patients treated with either electroconvulsive therapy (ECT) (n = 20) or (rTMS) (n = 21).


METHODS
Patients diagnosed with major depressive disorder with or without psychotic features referred for ECT were randomly assigned to receive either ECT or rTMS. Forty-one patients who responded to either treatment constituted the sample. Patients were followed on a monthly basis and outcomes were determined with the Hamilton Rating Scale for Depression-17 items (HRSD) and the Global Assessment of Functioning (GAF) scales. Medications were routinely prescribed.


RESULTS
There were no differences in the 6-month relapse rate between the groups. Overall, 20% of the patients relapsed (four from the ECT group and four from the rTMS group). Patients reported equally low and not significantly different scores in the HRSD (ECT group 8.4 +/- 5.6 and TMS group 7.9 +/- 7.1) and the GAF (ECT group 72.8 +/- 12 and TMS group 77.8 +/- 17.1) at the 6-month follow up.


CONCLUSIONS
Patients treated with rTMS do as well as those treated with ECT at the 3- and 6-month follow-up points. These data suggest that the clinical gains obtained with rTMS last at least as long as those obtained with ECT.
Dannon
Pinhas N
PN
Psychiatry Division, ECT-TMS Unit, Chaim Sheba Medical Center, 52621 Tel Hashomer, Israel.
Dolberg
Ornah T
OT
Schreiber
Shaul
S
Grunhaus
Leon
L
D003865:Major Depressive Disorder / Q000523:psychology / Q000628:therapy*; D004565:Electroconvulsive Therapy; D004574:Electromagnetic Fields; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008280:Magnetics; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome