Research projects

A randomised controlled trial of magnetic seizure therapy in major depressive disorder

Principal researchers

Professor Paul Fitzgerald

Institution

Monash University and the Alfred Hospital

Funding

$121,890

Award type

beyondblue Victorian Centre of Excellence

Project completion year

2016

Background

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.

The development of a new treatment with similar efficacy, but which minimises these side effects, would have great clinical value. One highly promising possibility is magnetic seizure therapy (MST). MST involves replacing the electrical stimulation used in ECT with a magnetic stimulus. This appears to be able to produce similar clinical effects but without the disabling cognitive side effects related to ECT. 

Should MST be shown to have similar efficacy to ECT but with reduced side-effects, it is envisioned that it could rapidly replace ECT in clinical practice throughout Australia and indeed internationally with substantial ongoing benefits to patients. 

Project description

The study involved:

  • A total of 60 patients in the study completing a treatment course.
  • People in the trial had severe depression and between the ages of 18 and 75. 
  • A randomised double-blind clinical trial with two treatment arms.

Findings

  • The researchers compared the effects of a new type of depression treatment, Magnetic Seizure Therapy (MST), to Electroconvulsive Therapy (ECT) in a group of participants diagnosed with treatment resistant depression.
  • All of the participants showed a significant improvement in their mood over the course of the 4 week treatment trial, irrespective of whether they received ECT or MST.
  • 38% of patients who completed the trial experienced either a partial or complete clinical response to the treatment.
  • Cognitive side effects, i.e. problems with memory and attention, are often reported following ECT. Therefore, the effects of ECT and MST on cognition were also investigated.
  • Before and after the course of treatment participants were asked a series of questions about their past (i.e. where did you go on your last holiday). Those participants who had MST were able to retain more information (82%), compared to those who had ECT (72%); although this was not a significant difference.
  • The participants who underwent MST showed significantly improved performances on cognitive tests of psychomotor speed, immediate verbal memory, and executive functioning. They also showed near significant improvements on attention, associate learning, delayed verbal memory and working memory. There was no reduction in cognitive performance across any of the tasks in the MST group.
  • The participants who underwent ECT largely exhibited non-significant reductions in performances across the cognitive tasks. They did show a significantly reduced performance on a test of psychomotor speed, and a near significant reduction on a test of executive functioning.

​Overall researchers found MST to be as effective as ECT in reducing depression symptoms. Researchers found no cognitive side effects following MST, while ECT was found to produce mild cognitive side effects in the current study.

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