TMS Blog

TMS or ECT? A Mental Health Consumer Weighs the Options When should a patient use ECT or TMS?

After reading 3,000 Pulses Later (link is external) in 48 hours, two questions pounded in my head. How does a psychiatrist determine whether TMS (transcranial magnetic stimulation) or ECT (electroconvulsive therapy) is the right treatment for a depressed patient? And, as an informed consumer of medical care, when is the right time for patients to lobby their doctors for either TMS or ECT? Martha Rhode's (link is external)new memoir regarding her positive experience with Transcranial Magnetic Stimulation (TMS) made me wonder if some of my information about these two procedures was out of date. If her experience with TMS is the norm, I wondered if TMS would be a good alternative for me if I ever became seriously depressed again.

Comparing the Effects of Repetitive Transcranial Magnetic Stimulation and Electroconvulsive Therapy in the Treatment of Depression: A Systematic Review and Meta-Analysis

-Beppe Micallef-Trigona

Electroconvulsive therapy (ECT) is the longest standing psychiatric treatment available and has unequivocal benefit in severe depression. However this treatment comes with a number of side effects such as memory impairment. On the other hand, Repetitive Transcranial Magnetic Stimulation (rTMS) is a relatively new form of treatment which has been shown to be efficacious in patients suffering from a number of psychopathologies, including severe depression, with few reported side effects. Due to its potential therapeutic efficacy and lack of side effects, rTMS has gained traction in the treatment of depression, with a number of authors keen to see it take over from ECT. However, it is not clear whether rTMS represents a therapeutic alternative to ECT. This meta-analysis will therefore compare the “gold standard” treatment for severe depression, with the relatively new but promising rTMS. A literature search will be performed with the intention to include all randomised clinical trials. The null hypothesis is that there is no difference in the antidepressant efficacy between the two types of treatment modalities. Statistical analysis of Hamilton Depression Rating Scale (HDRS) scores will be performed.