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Low frequency rTMS, inhibits the antidepressive effect of ECT. A pilot study

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  • Poul Erik Buchholtz
  • Mahmoud Ashkanian
  • Simon Hjerrild
  • Line Kirstine Hauptmann
  • Torben Devantier
  • Paulina Jensen
  • Sanne Wissing
  • Mette Thorgaard
  • Maria Speed
  • Rene Børge Korsgaard Brund
  • Poul Videbech
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OBJECTIVE: Low frequency rTMS of the prefrontal cortex have been shown to have a statistically and clinically significant antidepressant effect. The present pilot study was carried out to investigate if right prefrontal low frequency rTMS as an add-on to ECT accelerates the antidepressant effect and reduces cognitive side effects.

METHODS: In this randomized, controlled, double blind study thirty-five patients with major depression were allocated to ECT+placebo or ECT+ low frequency right prefrontal rTMS. The severity of depression was evaluated during the course using the Hamilton scale for depression (the 17-item as well as the 6-item scale) and the Major Depression Inventory. Furthermore, neuropsychological assessment of cognitive function was carried out.

RESULTS: The study revealed no significant difference between the two groups for any of the outcomes, but with a visible trend to lower scores for MDI after treatment in the placebo group. The negative impact of ECT on neurocognitive functions was short lived and scores on logical memory were significantly improved compared to baseline 4 weeks after last treatment. The ECT-rTMS group revealed generally less impairment of cognitive functions than the ECT-placebo group.

CONCLUSION: The addition of low frequency rTMS as an add-on to ECT treatment did not result in an accelerated response. On the contrary, the results suggest that low frequency rTMS could inhibit the antidepressant effect of ECT.

Original languageEnglish
JournalActa Neuropsychiatrica
Pages (from-to)1-27
Number of pages27
ISSN1601-5215
DOIs
Publication statusPublished - 27 Jul 2020

ID: 60687731