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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by ed_uk on December 15, 2004, at 9:02:09
Neuropsychopharmacology. 2003 Nov;28(11):2045-8.
Magnetic seizure therapy improves mood in refractory major depression.
Kosel M, Frick C, Lisanby SH, Fisch HU, Schlaepfer TE.
Department of Psychiatry, University Hospital Bern, Switzerland.
This report describes the successful treatment of a patient suffering from an episode of drug-resistant major depression using magnetic seizure therapy (MST). The patient suffered from recurrent major depression since adolescence. MST is a novel brain stimulation method using transcranial magnetic stimulation at convulsive parameters in order to induce therapeutic seizures under general anesthesia in the same setting used for electroconvulsive therapy (ECT). The first use of therapeutic magnetic seizure induction in a psychiatric patient took place at the University Hospital in Bern, Switzerland, in May 2000. Results of a recent randomized, within-subject, double-masked trial comparing ECT and MST in 10 patients indicate that MST appears to have less subjective and objective side effects, is associated with faster recovery of orientation, and is superior to ECT on measures of attention, retrograde amnesia, and category fluency. ECT has an unparalleled and well-documented efficacy in severe depression but is associated with cognitive side effects. MST is currently under study in several centers with respect to its antidepressant efficacy. We report here on the treatment of a patient with refractory major depression (DSM IV-R), who underwent a series of 12 sessions of MST in an inpatient setting. Baseline Hamilton Depression Rating Scale (HRSD-21) of 33 and Beck Depression Inventory (BDI) of 40 decreased to 6 and 11 respectively, 1 week after completion of the MST trial. Measures of cognitive functions support the hypothesis that MST is associated with a less severe profile of cognitive side effects. [(99m)Tc]-HMPAO SPECT studies (baseline and 4 days after the completion of the MST trial) point to a raise of blood flow at baseline in the left fronto-parietal region and the brainstem. Our preliminary data support the prospect of antidepressant efficacy of MST and point to a benign cognitive side-effect profile in a patient suffering from severe treatment-resistant major depression.
Posted by tensor on December 15, 2004, at 10:33:14
In reply to Magnetic Seizure Therapy versus ECT, posted by ed_uk on December 15, 2004, at 9:02:09
Hi Ed,
very interesting article. Somehow i would feel more comfortable with a magnetic field, than an electrical current. I don't know why, electricity sounds so primitive. Although both causes seizures, it seems that MST causes less amnesia and other side effects. The article is from 2003, i wonder how far they've come today.
/Mattias
Posted by ed_uk on December 15, 2004, at 10:55:10
In reply to Interesting! » ed_uk, posted by tensor on December 15, 2004, at 10:33:14
Hi Mattias,
I know what you mean, there is something frightening about electricity. I once received an electric shock from the mains!!
Perhaps there are ongoing clicical trials of MST, I don't know.
Have you had your appointment?
Ed.
Posted by tensor on December 15, 2004, at 10:59:16
In reply to Re: Interesting! » tensor, posted by ed_uk on December 15, 2004, at 10:55:10
Posted by Dan Perkins on December 15, 2004, at 12:49:36
In reply to Magnetic Seizure Therapy versus ECT, posted by ed_uk on December 15, 2004, at 9:02:09
I am skeptical.
I am participating in a study of Transcranial Magnetic Stimulation (like MST w/o the seizure), under the care of one of the doctors who authored the study you are referring to. I have completed 27 of 30 40-minute-long procedures and have had absolutely no improvement in my depression. I have heard from a lot of people who have had TMS, and very few have experienced positive results.
MST is different, of course, because you have an actual seizure instead of just being exposed to repeated magnetic impulses (which are quite painful, by the way), but I still have my doubts. Both TMS and MST have been around for a while but neither of them has been approved for widespread use yet. This makes me believe that MST like TMS may not live up to the hype.
Posted by ed_uk on December 15, 2004, at 13:01:23
In reply to Re: Magnetic Seizure Therapy versus ECT, posted by Dan Perkins on December 15, 2004, at 12:49:36
Hi Dan,
Thank you for your response. Would you be interested in trying MST if rTMS doesn't work? Have you ever had ECT?
Regards,
Ed.
Posted by Dan Perkins on December 15, 2004, at 14:49:51
In reply to Re: Magnetic Seizure Therapy versus ECT » Dan Perkins, posted by ed_uk on December 15, 2004, at 13:01:23
Good question. After 5 1/2 weeks, with 28 treatments down and only 2 left with absolutely no change in my depression or in anything else, I would first of all have to say that I am already assuming that rTMS was a bust for me.
As far as MST, I would have to do a lot more research on it b/f I decided either way. Specifically I would really want to read first hand accounts from people who have had MST. To my mind, the only way to cut through the hype and bias in the research and reporting on any antidepressant treatment (including MST) is to hear from people who have had the treatment.
For example, I have read tons of positive, promising things about rTMS in news stories and journal articles, but of all the first hand accounts I have read about it, I think only one or two of them had anything positive to say about it.
Despite the positive things I have read about MST, I have yet to see anything first hand (positive or negative) from anyone who has had the treatment.
I think there is a tendancy to think that magnets are no big deal and that there is no harm in them, but they really are quite powerful. The rTMS treatments hurt like hell and MST is, by definition, strong enough to cause a seizure. Also, there is general anesthesia involved. So I wouldn't rush into MST thinking it's no big thing.
I have never had ECT and I'm not sure that I ever would. Frankly, it scares me. It's not the irrational fear of ECT born of misinformation that many people have. I am wary of ECT b/c I have read several first-hand accounts of ECT destroying significant amounts of some people's memory and ruining people's lives. I know that ECT is a godsend for many, but the fact is that it has done a lot more harm than good for some people.
> Would you be interested in trying MST if rTMS doesn't work? Have you ever had ECT?
>
> Regards,
> Ed.
Posted by ed_uk on December 16, 2004, at 6:38:22
In reply to Re: Magnetic Seizure Therapy versus ECT, posted by Dan Perkins on December 15, 2004, at 14:49:51
Hi Dan,
Yes, I absolutely agree that first-hand accounts from people who have had MST are a must. I suppose the fact that MST involves a seizure might mean that it could help your depression despite the failure of rTMS.
To anyone....
If you have had MST please share your experience!
Regards,
Ed.
Posted by linkadge on December 16, 2004, at 16:04:06
In reply to Has anyone had MST???, posted by ed_uk on December 16, 2004, at 6:38:22
I live in canada as well, and am wondering where in canada you live??
Linakdge
Posted by denise1904 on December 19, 2004, at 12:59:59
In reply to Re: Magnetic Seizure Therapy versus ECT, posted by Dan Perkins on December 15, 2004, at 12:49:36
Hi Dan,
I also tried rTMS, I travelled from the Uk to Vancouver and it did absolutely nothing although the guy who was giving me the treatments really wanted it to work for me bless him. He told me that they'd had lots of good results from it at the clinic and I couldn't understand how. I felt like a bit of a failure for the fact that it didn't work, felt like throwing myself off the bridge at one point.
So I don't understand why some of these studies conclude that it will be a possible alternative to ECT. I've heard on one person on here though (Pfinstegg) who found it very helpful. Just goes to show then. But I personally don't think it will be very affective for rTMS.
What are you thinking of trying next if this treatment doestn't pan out?
Denise
Posted by denise1904 on December 19, 2004, at 13:20:24
In reply to Re: To Dan Perkins - My experience with rTMS, posted by denise1904 on December 19, 2004, at 12:59:59
Hi,
I was just wondering if as it is the seizure itself that is supposed to invoke the good mood then why aren't people who have epilepsy always on a high?
I also suffered from a seizure just over three years ago when I had taken too much medication and don't remember coming out of it in a particularly good mood, infact I felt as bad as ever, not really concerned about the fact that I'd had a seizure, just about the fact that I was soooooo depressed.
Does this mean that any kind of treatment that involved evoking a seizure wouldn't work for me?
Denise
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