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Magnetic seizure therapy is efficacious and well tolerated for treatment-resistant bipolar depression: an open-label clinical trial
- Source :
- J Psychiatry Neurosci
- Publication Year :
- 2020
- Publisher :
- Joule Inc., 2020.
-
Abstract
- Background: Treatment-resistant bipolar depression can be treated effectively using electroconvulsive therapy, but its use is limited because of stigma and cognitive adverse effects. Magnetic seizure therapy is a new convulsive therapy with promising early evidence of antidepressant effects and minimal cognitive adverse effects. However, there are no clinical trials of the efficacy and safety of magnetic seizure therapy for treatment-resistant bipolar depression. Methods: Participants with treatment-resistant bipolar depression were treated with magnetic seizure therapy for up to 24 sessions or until remission. Magnetic seizure therapy was applied over the prefrontal cortex at high (100 Hz; n = 8), medium (50 or 60 Hz; n = 9) or low (25 Hz; n = 3) frequency, or over the vertex at high frequency (n = 6). The primary outcome measure was the 24-item Hamilton Rating Scale for Depression. Participants completed a comprehensive battery of neurocognitive tests. Results: Twenty-six participants completed a minimally adequate trial of magnetic seizure therapy (i.e., ≥ 8 sessions), and 20 completed full treatment per protocol. Participants showed a significant reduction in scores on the Hamilton Rating Scale for Depression. Adequate trial completers had a remission rate of 23.1% and a response rate of 38.5%. Per-protocol completers had a remission rate of 30% and a response rate of 50%. Almost all cognitive measures remained stable, except for significantly worsened recall consistency on the autobiographical memory inventory. Limitations: The open-label study design and modest sample size did not allow for comparisons between stimulation parameters. Conclusion: In treatment-resistant bipolar depression, magnetic seizure therapy produced significant improvements in depression symptoms with minimal effects on cognitive performance. These promising results warrant further investigation with larger randomized clinical trials comparing magnetic seizure therapy to electroconvulsive therapy. Clinical trial registration NCT01596608; clinicaltrials.gov
- Subjects :
- Adult
Male
medicine.medical_specialty
Bipolar Disorder
Convulsive Therapy
medicine.medical_treatment
Magnetic Field Therapy
Prefrontal Cortex
law.invention
03 medical and health sciences
Depressive Disorder, Treatment-Resistant
0302 clinical medicine
Electroconvulsive therapy
Randomized controlled trial
law
Internal medicine
Outcome Assessment, Health Care
medicine
Humans
Pharmacology (medical)
Effects of sleep deprivation on cognitive performance
Adverse effect
Biological Psychiatry
business.industry
Skull
Hamilton Rating Scale for Depression
Middle Aged
030227 psychiatry
Clinical trial
Psychiatry and Mental health
Magnetic seizure therapy
Antidepressant
Female
business
030217 neurology & neurosurgery
Research Paper
Subjects
Details
- Language :
- English
- ISSN :
- 01596608
- Database :
- OpenAIRE
- Journal :
- J Psychiatry Neurosci
- Accession number :
- edsair.doi.dedup.....71dbaba692567065743638352ef6744c