Kate E Hoy1, Paul B Fitzgerald. 1. Monash Alfred Psychiatry Research Centre, The Alfred and Monash University School of Psychology and Psychiatry, Melbourne, Victoria, Australia. Kate.Hoy@med.monash.edu.au
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.
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.