The Use of ECT and MST in treating depression

Abstract

Electroconvulsive therapy (ECT) has been used clinically since 1938. Its most common use is in the treatment of depression: fi rst line treatment where rapid recovery is a priority, but more frequently as an effective treatment for patients who do not respond to pharmacological and psychological approaches. Whilst it is widely hailed as an effective treatment, concerns about its effect on cognition remain. The development of magnetic seizure therapy (MST) over the past decade has attempted to devise a therapy with comparable effi cacy to ECT, but without the associated cognitive side effects. The rationale for this is that MST uses magnetic fi elds to induce seizures in the cortex, without electrical stimulation of brain structures involved with memory. MST has been used successfully in the treatment of depression, yet there is a dearth of literature in comparison with ECT. We present a systematic review of the literature on ECT (from 2009ECT (from -2011 and MST (from 2001MST (from -2011.

Current electroconvulsive therapy practice and research in the geriatric population

“…MST presumably has a better localization of the site of initiation and focalization of propagation [249], which could cause fewer cognitive side effects and possibly have less impact on parasympathetic and sympathetic outflow, which cause HR and BP fluctuation [250]. However, the efficacy of MST in the treatment of depression has not been established [251], although MST has been found to be associated with rapid reorientation and intact anterograde and retrograde memory [252]. Elderly patients may benefit from MST because of its favorable side-effect profile compared with ECT if antidepressant effect of MST is comparable with or superior to ECT, and the treatment becomes FDA approved.…”

Efficacy of Electroconvulsive Therapy for Comorbid Frontotemporal Dementia with Bipolar Disorder

“…Repeated studies have shown the efficacy of ECT on unipolar as well as bipolar depression [7, 8]. ECT has also been shown effective in a case of catatonia resembling FTD [9].…”

Vagus Nerve Stimulation (VNS) and Other Augmentation Strategies for Therapy-Resistant Depression (TRD): Review of the Evidence and Clinical Advice for Use

“…MST is being investigated as an alternative to ECT for use under general anesthesia with assisted ventilation and continuous electroencephalographic (EEG) monitoring. MST has the potential for fewer side effects, such as cognitive dysfunction, than ECT (Lisanby et al, 2003 ; Allan and Ebmeier, 2011 ), but optimal stimulation parameters for MST are still being investigated. Most studies have used a coil placed at the vertex with a frequency of stimulation of 100 Hz, a pulse width of 0.2–0.4 ms, and a stimulation duration of 10 s (Kito, 2017 ).…”

“…Most studies have used a coil placed at the vertex with a frequency of stimulation of 100 Hz, a pulse width of 0.2–0.4 ms, and a stimulation duration of 10 s (Kito, 2017 ). There are no large-scale studies comparing MST to sham stimulation and no large-scale controlled studies of relapse following maintenance MST (mMST) with regard to prevention strategies, so the therapy is still in the experimental stage (Allan and Ebmeier, 2011 ).…”