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介绍磁惊厥疗法:一种治疗难治性抑郁症的新疗法。

Introducing magnetic seizure therapy: A novel therapy for treatment resistant depression.

机构信息

Monash Alfred Psychiatry Research Centre, The Alfred and Monash University School of Psychology and Psychiatry, Melbourne, Victoria, Australia.

出版信息

Aust N Z J Psychiatry. 2010 Jul;44(7):591-8. doi: 10.3109/00048674.2010.481278.

Abstract

OBJECTIVE

Electroconvulsive therapy (ECT) remains the only established therapy for the large percentage of patients with depression who fail to respond to standard treatments. It is commonly used but has substantial problems including the occurrence of cognitive side effects that are often highly distressing for patients. One highly promising potential alternative is magnetic seizure therapy (MST). This review provides an overview of the cognitive side effects of ECT and the attempts to overcome these, the history and development of MST is then reviewed, and finally a case study of the first patient treated in Australia with MST is presented.

METHODS

OVID and MEDLINE databases were used to search for the relevant literature. Reviews, meta-analyses and what were considered seminal articles were selected from the ECT literature to provide an overview of this large body of research. All of the known MST published work to date was included in this review.

RESULTS

The first patient treated in Australia underwent MST for treatment-resistant depression in October 2009. Extensive pre- and post-psychopathology and neurocognitive assessments were conducted. The patient no longer met criteria for a major depressive episode following eight MST treatments and has remained in remission at evaluations to date. She did not experience any disorientation following treatments and her neurocognitive assessments revealed no apparent MST-related cognitive side effects.

CONCLUSIONS

Research to date and our current findings provide considerable impetus to continue to vigorously investigate the use of MST in treatment resistant depression.

摘要

目的

电痉挛疗法(ECT)仍然是治疗对标准治疗无反应的大部分抑郁症患者的唯一有效疗法。ECT 应用广泛,但存在很多问题,包括认知副作用的发生,这通常会给患者带来极大的痛苦。一种很有前途的潜在替代方法是磁惊厥疗法(MST)。本文综述了 ECT 的认知副作用及其克服方法,然后回顾了 MST 的历史和发展,最后介绍了澳大利亚首例接受 MST 治疗的患者的病例研究。

方法

使用 OVID 和 MEDLINE 数据库搜索相关文献。从 ECT 文献中选择综述、荟萃分析和被认为是开创性的文章,以提供对这大量研究的概述。本综述纳入了迄今为止所有已知的 MST 已发表的研究。

结果

澳大利亚首例患者于 2009 年 10 月因难治性抑郁症接受 MST 治疗。进行了广泛的治疗前和治疗后精神病理学和神经认知评估。该患者在接受 8 次 MST 治疗后不再符合重性抑郁发作的标准,并且在迄今为止的评估中仍处于缓解状态。她在治疗后没有出现定向障碍,她的神经认知评估也没有显示出明显的与 MST 相关的认知副作用。

结论

迄今为止的研究结果和我们目前的发现为继续大力研究 MST 在治疗抵抗性抑郁症中的应用提供了重要动力。

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