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Low- and moderate-frequency magnetic seizure therapy help patients with treatment-resistant depression go into remission.
Magnetic seizure therapy may be an effective treatment for suicidality.
The findings of the new study suggested magnetic seizure therapy holds promise to treat suicidality in patients with treatment-resistant depression. Still, the efficacy of the treatment must be confirmed in additional trials of the use of the therapy.
Cory Weissman, MD, and a team of investigators determined the association of magnetic seizure therapy with suicidality in patients with treatment-resistant major depressive disorder. The colleagues included participants aged 18-85 years old who presented with treatment-resistant depression and were initially referred for electroconvulsive therapy, a very effective treatment for suicidality in mood disorders. Patients included in the study had a baseline score on the 24-item Hamilton Rating Scale for Depression (HRSD-24) of 21 or higher.
Participants underwent magnetic seizure therapy sessions 2-3 times per week until they either achieved remission from their depressive episode or they reached a maximum of 24 sessions.
Weissman and the investigators assessed patients every 3 weeks and at the end of the study with the Beck Scale for Suicidal Ideation (SSI) and HRSD-24. Further, the patients were followed for 6 months after the end of the treatment period.
The study included 67 patients (mean age, 46.3 years old; 60% women) who received a mean of 19.5 magnetic seizure therapy treatments. Among those who had treatment, 47.8% achieved remission from suicidality.
The mean Beck SSI score decreased from 10.9 at baseline to 6 at the end of the trial (P <.001). There were similar outcomes with the suicidality item of the HRSD-24.
Those treated with low-frequency and moderate-frequency magnetic seizure therapy had numerically higher rates of remission from suicidality (55.2% and 54.5%, respectively), than patients who were treated with high-frequency magnetic seizure therapy (25%). The differences between the rates did not reach statistical significance (P=.05).
The change in Beck SSI scores were large and statistically significant in the groups treated with low-frequency (1.43; 95% CI, .59-1.88) and moderate-frequency (.87; 95% CI, .28-1.35) magnetic seizure therapy. The effect size was not significant among patients in the high-frequency magnetic seizure therapy group (.42; 95% CI, -.35 to 1.04).
Investigators noted 58.3% of study completers achieved remission from suicidality based on the Beck SSI score. The overall Beck SSI score decreased from 10.6 at baseline to 4.8 at the end of the study (P <.001).
In a subgroup sensitivity analysis, those treated with low- and moderate-frequency magnetic seizure therapy had numerically higher rates of remission from suicidality (73.3% and 58.3%, respectively), than patients treated with high-frequency magnetic seizure therapy (33.3%). The differences between the rates were not statistically significant (P=.05).
Although magnetic seizure therapy appeared to be effective and promising to treat suicidality, efficacy will need to be further confirmed in future trials on the treatment at low-to-moderate frequencies.
The study, “Magnetic Seizure Therapy for Suicidality in Treatment-Resistant Depression,” was published online in JAMA Network Open.