Confirmatory Efficacy and Safety Trial of Magnetic Seizure Therapy for Depression (CREST-MST): study protocol for a randomized non-inferiority trial of magnetic seizure therapy versus electroconvulsive therapy

Daskalakis, Zafiris J.; Tamminga, Carol; Throop, Alanah; palmer, lucy; Dimitrova, Julia; Farzan, Faranak; Thorpe, Kevin E.; McClintock, Shawn M.; Blumberger, Daniel M.

doi:10.1186/s13063-021-05730-7

Cited by 11 publications

(5 citation statements)

References 65 publications

(70 reference statements)

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“…Cognitive SEs as measured 4-hours post-session with Wisconsin Card Sorting test and Weschler memory scale-revised favored MST over ECT, but there were no data to determine if these effects were sustainable. Another non-inferiority randomized double blind study is currently underway to compare the efficacy and tolerability of MST compared to RUL-ECT in patients with treatment-resistant depression 71 .…”

Section: Optimizing Dosing and Administration Of Ectmentioning

confidence: 99%

Recent advances in electroconvulsive therapy in clinical practice and research

Mukhtar¹,

Regenold²,

Lisanby³

2023

Fac Rev

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Electroconvulsive therapy (ECT), the oldest somatic therapy still in use in psychiatry today, remains one of the most effective therapeutic interventions for a wide variety of psychiatric disorders. In this article, we review some of the recent advances in ECT that are currently being researched and implemented in clinical practice. We explore recent studies that point to the potential therapeutic benefit and safety of ECT in COVID-19-related neuropsychiatric complications and special populations (such as the elderly and pregnant persons) that are generally at higher risk of having adverse effects from psychotropic medications. We highlight studies that performed a head-to-head comparison of ECT and ketamine, which has shown promise for treatment-resistant depression and acute suicidality. Researchers continue to explore different ways of using ECT by modifying the treatment parameters to maintain efficacy and decrease side effects. Neurocognitive side effects remain one of the major drawbacks to its use and contribute to the negative stigma of this highly effective treatment. In this regard, we describe attempts to improve the safety of ECT by modifying dosing parameters, novel electrode placements, and the addition of augmenting agents with the aim of decreasing side effects and improving efficacy. This review identifies some of the recent advances in the last few years in ECT research while also highlighting areas where further research is needed.

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Section: Optimizing Dosing and Administration Of Ectmentioning

confidence: 99%

Recent advances in electroconvulsive therapy in clinical practice and research

Mukhtar¹,

Regenold²,

Lisanby³

2023

Fac Rev

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“…It inferred a possibility of using MST to treat pharmacotherapy-resistant PTSD patients that may have suicidal intentions. On the other hand, the application of MST is nearly identical to ECT, which means it would be a method that can be implanted quickly and cheaply, as most hospitals have ECT therapy devices [82].…”

Section: Magnetic Seizure Therapy (Mst)mentioning

confidence: 99%

Post-traumatic stress disorder and neuromodulation methods in treating PTSD

Wang

2024

Third International Conference on Biological Engineering and Medical Science (ICBioMed2023)

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In this review work, the article will go through post-traumatic stress disorder (PTSD) in detail. In the introduction section, the review will first introduce PTSD as a whole. The type of treatment will be stated in order of severity of symptoms. Then, one paragraph regarding the genetic heritability of PTSD is provided. The details of brain regions affected by PTSD and differences in symptoms will also be explained in this review. Using the information provided, the review will analyze why Neuromodulation is a promising treatment for PTSD. In the body section, the review will describe ten different neuromodulations that either have been implanted to treat PTSD or can be a treatment for the disorder. These ten methods include non-invasive and invasive techniques, as the two can be applied in different stages of this neurological disorder. Some neuromodulation is not yet used to treat PTSD, yet they have been proven helpful in other brain(psychiatric) disorders. In the discussion, the review will cover any neuromodulation methods that are not included and comment on those. In the end, the review will emphasize the need to find practical solutions to PTSD and the idea of pushing non-invasive neuromodulation (brain stimulation) into the future treatment of PTSD.

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“…In addition, results from RCTs have supported the efficacy of magnetic seizure therapy, with additional evidence demonstrating continuation of effect 250,251 . A Cochrane review did not identify a significant difference between this therapy and ECT in adults with TRD 252 .…”

Section: Management Of Treatment‐resistant Depressionmentioning

confidence: 99%

Treatment‐resistant depression: definition, prevalence, detection, management, and investigational interventions

McIntyre,

Alsuwaidan,

Baune

et al. 2023

World Psychiatry

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Treatment‐resistant depression (TRD) is common and associated with multiple serious public health implications. A consensus definition of TRD with demonstrated predictive utility in terms of clinical decision‐making and health outcomes does not currently exist. Instead, a plethora of definitions have been proposed, which vary significantly in their conceptual framework. The absence of a consensus definition hampers precise estimates of the prevalence of TRD, and also belies efforts to identify risk factors, prevention opportunities, and effective interventions. In addition, it results in heterogeneity in clinical practice decision‐making, adversely affecting quality of care. The US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have adopted the most used definition of TRD (i.e., inadequate response to a minimum of two antidepressants despite adequacy of the treatment trial and adherence to treatment). It is currently estimated that at least 30% of persons with depression meet this definition. A significant percentage of persons with TRD are actually pseudo‐resistant (e.g., due to inadequacy of treatment trials or non‐adherence to treatment). Although multiple sociodemographic, clinical, treatment and contextual factors are known to negatively moderate response in persons with depression, very few factors are regarded as predictive of non‐response across multiple modalities of treatment. Intravenous ketamine and intranasal esketamine (co‐administered with an antidepressant) are established as efficacious in the management of TRD. Some second‐generation antipsychotics (e.g., aripiprazole, brexpiprazole, cariprazine, quetiapine XR) are proven effective as adjunctive treatments to antidepressants in partial responders, but only the olanzapine‐fluoxetine combination has been studied in FDA‐defined TRD. Repetitive transcranial magnetic stimulation (TMS) is established as effective and FDA‐approved for individuals with TRD, with accelerated theta‐burst TMS also recently showing efficacy. Electroconvulsive therapy is regarded as an effective acute and maintenance intervention in TRD, with preliminary evidence suggesting non‐inferiority to acute intravenous ketamine. Evidence for extending antidepressant trial, medication switching and combining antidepressants is mixed. Manual‐based psychotherapies are not established as efficacious on their own in TRD, but offer significant symptomatic relief when added to conventional antidepressants. Digital therapeutics are under study and represent a potential future clinical vista in this population.

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Confirmatory Efficacy and Safety Trial of Magnetic Seizure Therapy for Depression (CREST-MST): study protocol for a randomized non-inferiority trial of magnetic seizure therapy versus electroconvulsive therapy

Cited by 11 publications

References 65 publications

Recent advances in electroconvulsive therapy in clinical practice and research

Recent advances in electroconvulsive therapy in clinical practice and research

Post-traumatic stress disorder and neuromodulation methods in treating PTSD

Treatment‐resistant depression: definition, prevalence, detection, management, and investigational interventions

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