Transcranial Pulsed Electromagnetic Fields for Treatment-Resistant Depression: A Multicenter 8-week Single-Arm Cohort Study
Larsen et. al. Eur Psychiatry, 63 (1) PMID 32093804
I put "ECT-related" in quotation marks because I'm not sure how related they are.
58 patients with treatment-resistant depression were treated with this new technology, T-PEMF. Patients administered their own treatment at home in the outpatient part of the study.
Among the "severely depressed" patients only 16.7% responded. There were 19 ECT non-responders in the cohort: 10/19 with "non chronic depression" had 50% response, 30% remission rates, 9/19 with "chronic depression" had 33% response and 11.1% remission rates.
These authors write: "The indication for T-PEMF as compared with that of rTMS and ECT thus needs to be clarified in the future. ECT seems to be more effective than rTMS for depression, especially in the short term, particularly for patients suffering from psychotic depression, severe suicidality, and lack of fluid intake."
Ya think? Call me a Luddite if you will, but I find this type of offhand conflation of ECT with other new and unproven technologies quite naive at best, irresponsible at worst.
Also, as I have mentioned in several prior blog posts, the concept of TRD is problematic, and it is not at all clear if the population in a study such as this has much overlap with typical ECT patient populations. Even the ECT non-responders may not, because when ECT fails, it is often because the patient does not have a biological, ECT-responsive illness. Of course, some patients are truly ECT-nonresponders, even when given fully adequate trials of ECT, but the percentage of appropriately diagnosed patients in this category is small.
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