Posted by Psychquackery on July 30, 2003, at 7:29:44
In reply to Re: ECT/rTMS, posted by linkadge on July 29, 2003, at 18:42:57
> There is actually much debate over weather the seizure has anything to do with efficacy of of ECT.
LOL That is entirely untrue. No ECT doctor worth his salt would consider a session of ECT to be successful unless a full grand mal seizure was induced. There is ZERO argument within the psychiatric establishment regarding the importance of the seizure in successful ECT.
I would like to see this debate regarding the importance of the seizure...please post citations for that please.
> A friend of mine with epilepsy and depression, had recurrent grand mal seizures which always resulted in depression. However, ECT worked wonderfully for him.
> The electrical stimulation of both forms of treatemt have effects on electrical activity in the brain. I have had sucessful TMS treatments and bad ones. The placement, frequency, duration and intensity are all some of the variables that can result in sucess or failue of the treatment. TMS is a very preliminary procedure, which has definately not been perfected.
This is not true. rTMS, due to its inherent lack of a grand mal seizure, just lacks the power that conventional ECT has. Some of these rTMS researchers are trying to prove that rTMS has the potential ECT has for treating truly severe, psychotic depressed conditions. However none of the studies have shown rTMS to be as effective as ECT for psychotic depression or mania...the most severe mood disorders.
> Scientifically, both have similar effects on rat brain cortisol, BDNF, NGF, serotonin receptor expression etc.
ECT stimulates deep brain structures like the thalmus and pituitary gland. It results in profound neuroendocrine changes which kicks depression in the butt. rTMS does not have these capabilities.
> I would personally not limit TMS to be any more or less effective than ECT untill the procedure is better understood and/or perfected.
I would rate it to be much less effect than conventional (bilateral) ECT.
I will give you one thing though. The side effect profile of rTMS is extremely benign. I personally found it to have zero side effects. None at all. But I dont think its as potent or effective as conventional ECT at treating severe mood disorders.