Department of Psychiatry and Psychotherapy, Sigmund-Freud-Strasse 25, University Hospital, Bonn, Germany.
J Psychiatr Res. 2011 May;45(5):569-76. doi: 10.1016/j.jpsychires.2010.09.008. Epub 2010 Oct 16.
Major depression is a common mental health problem and associated with significant morbidity and mortality, including impaired social and physical functioning and increased risk for suicide. Electroconvulsive therapy (ECT) is highly efficacious in treatment-resistant depressive disorders, but cognitive side effects are frequently associated with the treatment. Magnetic seizure therapy (MST) is a form of convulsive therapy, using magnetic fields in order to induce therapeutic seizures. First studies suggested that cognitive side effects of MST, including postictal recovery time, are more benign than those resulting from ECT treatment. In this open-label study we tested the hypothesis that MST is associated with clinically significant antidepressant effects in treatment-resistant depression (TRD) as an add-on therapy to a controlled pharmacotherapy. Twenty patients suffering from TRD were randomly assigned to receive either MST or ECT starting from July 2006 until November 2008. Primary outcome measure was antidepressant response assessed by Montgomery Åsberg Depression Scale. Secondary outcome measures included Hamilton Depression Rating Scale, Hamilton Anxiety Scale, Beck Depression Inventory and 90-Item Symptom Checklist. Antidepressant response (improvement of 50% in MADRS ratings) was statistically significant and of similar size in both treatment groups. Cognitive side effects were observed in neither group. Characteristics in MST- and ECT-induced seizures were comparable, especially regarding ictal activity and postictal suppression. Thus, MST may be a potential alternative to ECT if efficacy and safety are validated in larger clinical trials.
重度抑郁症是一种常见的心理健康问题，与显著的发病率和死亡率相关，包括社交和身体功能受损以及自杀风险增加。电抽搐治疗（ECT）在治疗抵抗性抑郁症方面非常有效，但治疗常常伴随着认知副作用。磁惊厥治疗（MST）是一种惊厥治疗形式，使用磁场来诱导治疗性惊厥。初步研究表明，MST 的认知副作用，包括发作后恢复时间，比 ECT 治疗引起的副作用更为良性。在这项开放性标签研究中，我们检验了以下假设：作为一种附加疗法，MST 与经药物控制的治疗相比，在治疗抵抗性抑郁症（TRD）中具有显著的抗抑郁效果。20 名患有 TRD 的患者从 2006 年 7 月到 2008 年 11 月被随机分配接受 MST 或 ECT。主要结局指标是用蒙哥马利抑郁量表评估的抗抑郁反应。次要结局指标包括汉密尔顿抑郁量表、汉密尔顿焦虑量表、贝克抑郁量表和 90 项症状清单。在两组治疗中，抗抑郁反应（MADRS 评分改善 50%）均具有统计学意义且效果相当。两组均未观察到认知副作用。MST 和 ECT 诱导的惊厥的特征是可比的，尤其是关于发作活动和发作后抑制。因此，如果在更大的临床试验中验证了疗效和安全性，MST 可能成为 ECT 的潜在替代疗法。
