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Posts Tagged ‘ECT’

The St. Petersburg Times (3/3, Stein, http://tinyurl.com/TMS-depression) reports that for patients who don’t respond to drugs and counseling, TMS (transcranial magnetic stimulation) offers an alternative to electric shock therapy, still used to treat depression despite its reputation in popular culture as a barbaric treatment.  Many physicians consider ECT the gold standard treatment for severe depression that doesn’t respond to other remedies.  It is considered safe, but side effects can include short-term memory loss.  TMS involves using an electromagnetic coil to beam pulsations through the skull to stimulate a part of the brain thought to be involved in depression.  By contrast, the primary discomfort associated with TMS is a staccato tapping noise.  Another consideration is cost, which can reach $10,000 and isn’t routinely covered by insurance since it is relatively new and its availability limited. At USF, the treatment costs about $350 per session, and patients need about 10 to 20 procedures.  Clinical trials on TMS have yielded mixed results, and the U.S. Food and Drug Administration received some criticism when it approved the therapy for use in treatment-resistant depression over a year ago.  At least some questions may be settled in May, when the results of a five-year study sponsored by the NIH will be published in the Archives of General Psychiatry.

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ectMedscape (7/10, Kelly) reported that, according to a study published in the July issue of Archives of General Psychiatry, “combining antidepressant” medications “with electroconvulsive therapy (ECT) does a better job of reducing symptoms of severe depression and causes less memory loss than using ECT alone.” For the study, researchers from Columbia University “randomized 319 patients who had major depression to receive either a placebo or one of two antidepressants: nortriptyline or venlafaxine, starting the afternoon following the first ECT treatment.” Electroconvulsive therapy “was given three times per week.” Meanwhile “a battery of cognitive tests was administered before ECT and one to four days following all ECT.” The team found that “using either antidepressant during ECT improved depression more than ECT alone and that adding nortriptyline to ECT increased remission rates by about 15 percent.” In addition, “patients who received nortriptyline during ECT had fewer memory problems than those in the venlafaxine group.”

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