ArticlePublished: 05 September 2019

ArticlePublished: 05 September 2019Magnetic seizure therapy (MST) for major depressive disorderZafiris J. Daskalakis, Julia Dimitrova, Shawn M. McClintock, Yinming Sun, Daphne Voineskos, Tarek K. Rajji, David S. Goldbloom, Albert H. C. Wong, Yuliya Knyahnytska, Benoit H. Mulsant, Jonathan Downar, Paul B. Fitzgerald & Daniel M. Blumberger Neuropsychopharmacology volume 45, pages276–282(2020)Cite this article546 Accesses1 Citations5 AltmetricMetrics detailsAbstractElectroconvulsive therapy (ECT) is effective for major depressive disorder (MDD) but its effects on memory limit its widespread use. Magnetic seizure therapy (MST) is a potential alternative to ECT that may not adversely affect memory. In the current trial, consecutive patients with MDD consented to receive MST applied over the prefrontal cortex according to an open-label protocol. Depressive symptoms and cognition were assessed prior to, during and at the end of treatment. Patients were treated two to three times per week with high-frequency MST (i.e., 100 Hz) (N = 24), medium frequency MST (i.e., 60 or 50 Hz) (N = 26), or low-frequency MST (i.e., 25 Hz MST) (N = 36) using 100% stimulator output. One hundred and forty patients were screened; 86 patients with MDD received a minimum of eight treatments and were deemed to have an adequate course of MST; and 47 completed the trial per protocol, either achieving remission (i.e., 24-item Hamilton Rating Scale for Depression score 60% at two consecutive assessments; n = 17) or received a maximum of 24 sessions (n = 30). High-frequency (100 Hz) MST produced the highest remission rate (33.3%). Performance on most cognitive measures remained stable, with the exception of significantly worsened recall consistency of autobiographical information and significantly improved brief visuospatial memory task performance. Under open conditions, MST led to clinically meaningful reduction in depressive symptoms in patients with MDD and produced minimal cognitive impairment. Future studies should compare MST and ECT under double-blind randomized condition.IntroductionMajor depressive disorder (MDD) is a leading cause of global disease burden. It produces functional impairment and is associated with significant morbidity and mortality [1, 2]. About 33% of patients with MDD achieve remission of their depressive symptoms after a single trial of antidepressant medication. Even with multiple medication trials, 30–40% of patients do not improve significantly [3] and are categorized as suffering from treatment resistant depression (TRD).Electroconvulsive therapy (ECT) is the most effective treatment for TRD with remission rates between 40 and 70% [4]. However,