Magnetic Seizure Therapy for Unipolar and Bipolar Depression: A Systematic Review.

Eric Cretaz,André R Brunoni,Beny Lafer

doi:10.1155/2015/521398

Eric Cretaz, André R Brunoni + Show 1 more

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https://doi.org/10.1155/2015/521398

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Abstract

Objective. Magnetic seizure therapy (MST) is a novel, experimental therapeutic intervention, which combines therapeutic aspects of electroconvulsive therapy (ECT) and transcranial magnetic stimulation, in order to achieve the efficacy of the former with the safety of the latter. MST might prove to be a valuable tool in the treatment of mood disorders, such as major depressive disorder (MDD) and bipolar disorder. Our aim is to review current literature on MST. Methods. OVID and MEDLINE databases were used to systematically search for clinical studies on MST. The terms “magnetic seizure therapy,” “depression,” and “bipolar” were employed. Results. Out of 74 studies, 8 met eligibility criteria. There was considerable variability in the methods employed and samples sizes were small, limiting the generalization of the results. All studies focused on depressive episodes, but few included patients with bipolar disorder. The studies found reported significant antidepressant effects, with remission rates ranging from 30% to 40%. No significant cognitive side effects related to MST were found, with a better cognitive profile when compared to ECT. Conclusion. MST was effective in reducing depressive symptoms in mood disorders, with generally less side effects than ECT. No study focused on comparing MST to ECT on bipolar depression specifically.

Highlights

The results of this review show that Magnetic seizure therapy (MST) is as effective as Electroconvulsive therapy (ECT) in inducing generalized tonic-clonic seizures, both in animals and in humans
In most animal studies and some clinical studies MST led to less postictal suppression and less EEG amplitude compared to ECTinduced seizures, two studies reported similar EEG characteristics for both groups [44, 48]
Such results could possibly be related to the use of right unilateral electrodes (RUL-ECT) and low electric dose, which are associated with less cognitive loss but less effectiveness as well

Summary

Introduction

Mood disorders, such as major depressive disorder (MDD) and bipolar disorder (BD), are highly prevalent and debilitating conditions, associated with high suicidality rates, elevated treatment costs, and heavy social and economic burden [1]. The treatment of depressive episodes is associated with a 30–40% rate of nonresponse [2]. Electroconvulsive therapy (ECT) is regarded as the most effective treatment for depression [3], in both BD and MDD, with remission rates ranging from 50% to 75% [4,5,6]. ECT is effective for manic episodes, with reported remission rates of up to 85% [7,8,9,10,11]

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