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Repetitive transcranial magnetic stimulation is not as effective as electroconvulsive therapy for major depression

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 Q Is repetitive transcranial magnetic stimulation equivalent to electroconvulsive therapy?

METHODS

Embedded ImageDesign:

Randomised controlled equivalence trial.

Embedded ImageAllocation:

Concealed.

Embedded ImageBlinding:

Single blind (assessors blinded).

Embedded ImageFollow-up period:

Six months.

Embedded ImageSetting:

South London and Maudsley National Health Service Trust, London, and Pembury Hospital, Invicta Mental Health Trust, Kent, UK; recruitment January 2002 to August 2004.

Embedded ImagePatients:

Forty six right-handed adults (aged ⩾18 years) referred for electroconvulsive therapy (ECT) for major depression (Structured Clinical Interview for DSM-IV Axis I Disorders). Main exclusions: inability to receive repetitive transcranial magnetic stimulation (rTMS) or ECT (metallic plates in head, unfit for anaesthesia, history of seizures); rTMS or ECT in previous 6 months; dementia or other axis I diagnosis; substance misuse in previous 6 months.

Embedded ImageIntervention:

rTMS (15 sessions: daily for 5 days/week over 3 weeks) or ECT (bilateral or unilateral, twice weekly, number and duration dependent upon patient’s response, mean 6 sessions over 22 days).

Embedded ImageOutcomes:

Depression symptoms (17 …

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