Comparison between neurostimulation techniques rapid transcranial magnetic stimulation vs electroconvulsive therapy for the treatment of resistant depression: patient preference and cost-effectiveness
Racheli Magnezi,1 Emanuel Aminov,1 Dikla Shmuel,2 Merav Dreifuss,1 Pinhas Dannon1,2 1Public Health and Health Systems Management Program, Department of Management, Bar-Ilan University, Ramat Gan, 2Beer Yaakov Mental Health Center affiliated to Sackler School of Medicine, Tel Aviv University, Tel Av...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2016-08-01
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| Series: | Patient Preference and Adherence |
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| Online Access: | https://www.dovepress.com/comparison-between-neurostimulation-techniques-rapid-transcranial-magn-peer-reviewed-article-PPA |
| _version_ | 1818421550454407168 |
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| author | Magnezi R Aminov E Shmuel D Dreifuss M Dannon P |
| author_facet | Magnezi R Aminov E Shmuel D Dreifuss M Dannon P |
| author_sort | Magnezi R |
| collection | DOAJ |
| description | Racheli Magnezi,1 Emanuel Aminov,1 Dikla Shmuel,2 Merav Dreifuss,1 Pinhas Dannon1,2 1Public Health and Health Systems Management Program, Department of Management, Bar-Ilan University, Ramat Gan, 2Beer Yaakov Mental Health Center affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Objectives: Major depressive disorder (MDD) is a common disorder, widely distributed in the population, and is often associated with severe symptoms and functional impairment. It has been estimated that 30% of MDD patients do not benefit adequately from therapeutic interventions, including pharmacotherapy and psychotherapy. Treatment-resistant depression (TRD) is generally defined as a failure to achieve remission, despite therapeutic interventions. Aim: The most effective treatment alternatives for TRD are hospitalization, electroconvulsive therapy (ECT), and transcranial magnetic stimulation (TMS). Here we compared the clinical effectiveness of ECT and TMS, including success rates, patient responses, side-effect profiles, and financial worthiness. Results: We found that ECT (P<0.0001) was more effective than TMS (P<0.012) (not statistically significant in group effect) in TRD patients. However, ECT patients reported a higher percentage of side effects (P<0.01) and the TMS treatment scored better in terms of patient preference. The cost benefit of ECT was higher than that of TMS (US$2075 vs US$814). Patient’s preferences for treatment could be more intense in the TMS, if the TMS is included in the Health Maintenance Organization’s service list. Conclusion: We propose that both of these treatment options should be available in psychiatric wards, thus expanding the therapeutic toolkit for TRD. Keywords: ECT, TMS, treatment-resistant depression, cost benefit, patient preference |
| first_indexed | 2024-12-14T13:12:09Z |
| format | Article |
| id | doaj.art-9b68371b1c3a4638aa224663483d0304 |
| institution | Directory Open Access Journal |
| issn | 1177-889X |
| language | English |
| last_indexed | 2024-12-14T13:12:09Z |
| publishDate | 2016-08-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Patient Preference and Adherence |
| spelling | doaj.art-9b68371b1c3a4638aa224663483d03042022-12-21T23:00:11ZengDove Medical PressPatient Preference and Adherence1177-889X2016-08-012016Issue 11481148728256Comparison between neurostimulation techniques rapid transcranial magnetic stimulation vs electroconvulsive therapy for the treatment of resistant depression: patient preference and cost-effectivenessMagnezi RAminov EShmuel DDreifuss MDannon PRacheli Magnezi,1 Emanuel Aminov,1 Dikla Shmuel,2 Merav Dreifuss,1 Pinhas Dannon1,2 1Public Health and Health Systems Management Program, Department of Management, Bar-Ilan University, Ramat Gan, 2Beer Yaakov Mental Health Center affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Objectives: Major depressive disorder (MDD) is a common disorder, widely distributed in the population, and is often associated with severe symptoms and functional impairment. It has been estimated that 30% of MDD patients do not benefit adequately from therapeutic interventions, including pharmacotherapy and psychotherapy. Treatment-resistant depression (TRD) is generally defined as a failure to achieve remission, despite therapeutic interventions. Aim: The most effective treatment alternatives for TRD are hospitalization, electroconvulsive therapy (ECT), and transcranial magnetic stimulation (TMS). Here we compared the clinical effectiveness of ECT and TMS, including success rates, patient responses, side-effect profiles, and financial worthiness. Results: We found that ECT (P<0.0001) was more effective than TMS (P<0.012) (not statistically significant in group effect) in TRD patients. However, ECT patients reported a higher percentage of side effects (P<0.01) and the TMS treatment scored better in terms of patient preference. The cost benefit of ECT was higher than that of TMS (US$2075 vs US$814). Patient’s preferences for treatment could be more intense in the TMS, if the TMS is included in the Health Maintenance Organization’s service list. Conclusion: We propose that both of these treatment options should be available in psychiatric wards, thus expanding the therapeutic toolkit for TRD. Keywords: ECT, TMS, treatment-resistant depression, cost benefit, patient preferencehttps://www.dovepress.com/comparison-between-neurostimulation-techniques-rapid-transcranial-magn-peer-reviewed-article-PPAECTTMStreatment resistant depressioncost benefitpatient preference |
| spellingShingle | Magnezi R Aminov E Shmuel D Dreifuss M Dannon P Comparison between neurostimulation techniques rapid transcranial magnetic stimulation vs electroconvulsive therapy for the treatment of resistant depression: patient preference and cost-effectiveness Patient Preference and Adherence ECT TMS treatment resistant depression cost benefit patient preference |
| title | Comparison between neurostimulation techniques rapid transcranial magnetic stimulation vs electroconvulsive therapy for the treatment of resistant depression: patient preference and cost-effectiveness |
| title_full | Comparison between neurostimulation techniques rapid transcranial magnetic stimulation vs electroconvulsive therapy for the treatment of resistant depression: patient preference and cost-effectiveness |
| title_fullStr | Comparison between neurostimulation techniques rapid transcranial magnetic stimulation vs electroconvulsive therapy for the treatment of resistant depression: patient preference and cost-effectiveness |
| title_full_unstemmed | Comparison between neurostimulation techniques rapid transcranial magnetic stimulation vs electroconvulsive therapy for the treatment of resistant depression: patient preference and cost-effectiveness |
| title_short | Comparison between neurostimulation techniques rapid transcranial magnetic stimulation vs electroconvulsive therapy for the treatment of resistant depression: patient preference and cost-effectiveness |
| title_sort | comparison between neurostimulation techniques rapid transcranial magnetic stimulation vs electroconvulsive therapy for the treatment of resistant depression patient preference and cost effectiveness |
| topic | ECT TMS treatment resistant depression cost benefit patient preference |
| url | https://www.dovepress.com/comparison-between-neurostimulation-techniques-rapid-transcranial-magn-peer-reviewed-article-PPA |
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