Magnetic Seizure Therapy Matches ECT in Bipolar Depression with Better Tolerability
A randomized trial published in the American Journal of Psychiatry has found that magnetic seizure therapy (MST) achieved remission rates comparable to electroconvulsive therapy (ECT) in patients with bipolar depression. However, MST was associated with better tolerability and caused less impairment of autobiographical memory, suggesting it may offer a safer cognitive profile while maintaining antidepressant effectiveness. The study was conducted by Daniel M. and colleagues.
In order to assess the effectiveness and cognitive safety of both techniques, a well-designed, double-blind, randomized, parallel group pilot study was carried out. This study included people with bipolar depression that were randomly allocated into groups where they had received standard RUL-UB ECT and novel MST. Patients continued their therapy until they attained clinical remission, withdrew from the trial, or reached the upper limit of 21 sessions.
In order to have objective measurement criteria for evaluating the two therapies, researchers used two main criteria, namely clinical remission, which had been carefully evaluated using the standard 24 item Hamilton Rating Scale for Depression (HRSD-24) and cognitive side effects assessed via Autobiographical Memory Test (AMT).
Key findings:
- Of the 55 randomized subjects, 45 had an appropriate trial for response to treatment; among them, remission of depression was observed in 6 out of 20 (30.0%) of those belonging to the RUL-UB ECT group and 5 out of 25 (20.0%) of the MST group.
- A clinically significant decrease in autobiographical memory function, strictly defined as a decline of more than 25% in their AMT scores, was seen in 6 out of 27 (22.2%) subjects in the ECT group but only 2 out of 28 (7.1%) in the MST group.
- The secondary measures of functional improvement and reduced symptom severity were essentially equivalent in both groups.
In the randomized pilot study, MST is shown to have comparable efficacy to ECT with regard to alleviating depressive symptoms, but with better tolerability and less deterioration of autobiographic memory functioning. These results indicate that MST may become a valuable, cognition-sparing method of treating refractory bipolar depression. Nevertheless, due to the small number of patients participating in the pilot study, one should view the results obtained as preliminary.
Reference:
Blumberger, D. M., Vila Rodriguez, F., McClintock, S. M., Thorpe, K. E., Burhan, A. M., Foley, K., Goodman, M. S., Gregory, E. C., Kaster, T. S., Knyahnytska, Y., Tham, J., Trevizol, A. P., Voineskos, D., Zrenner, B., & Daskalakis, Z. J. (2026). Clinical and cognitive outcomes comparing right unilateral ultrabrief electroconvulsive therapy versus magnetic seizure therapy for bipolar depression: The CORRECT-BD trial. The American Journal of Psychiatry, appi.ajp.20250955, appiajp20250955. https://doi.org/10.1176/appi.ajp.20250955
