Antidepressant effects, of magnetic seizure therapy and electroconvulsive therapy, in treatment-resistant depression
Antidepressant effects, of magnetic seizure therapy and electroconvulsive therapy, in treatment-resistant depression
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DOI：
10.1016/j.jpsychires.2010.09.008
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发表时间：
2011-05-01
影响因子：
4.8
通讯作者：
Schlaepfer, Thomas E.
中科院分区：
文献类型：
--
作者：
Kayser, Sarah;Bewernick, Bettina H.;Schlaepfer, Thomas E.
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，包括社会和身体功能受损以及自杀风险增加。电休克疗法（ECT）对难治性抑郁症非常有效，但认知副作用经常与治疗有关。磁惊厥疗法（MST）是一种惊厥疗法，使用磁场来诱导治疗性癫痫发作。最初的研究表明，MST的认知副作用，包括发作后恢复时间，比ECT治疗的副作用更良性。在这项开放标签研究中，我们检验了MST与难治性抑郁症（TRD）的临床显著抗抑郁作用相关的假设，MST作为对照药物治疗的添加治疗，20例TRD患者随机分配接受MST或ECT，从2006年7月开始至2008年11月。主要结局指标为采用蒙哥马利阿斯伯格抑郁量表评估的抗抑郁反应。次要结果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项症状自评量表。两组均未观察到认知副作用。MST和ECT诱导的癫痫发作特征相当，特别是关于发作活动和发作后抑制。因此，MST可能是一个潜在的替代ECT的有效性和安全性，如果在更大的临床试验验证。(C)2010爱思唯尔有限公司保留所有权利。
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 Asberg 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. (C) 2010 Elsevier Ltd. All rights reserved.