University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository




Dr. Laura Witte



Objectives: This study describes the use of Electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) for physician assistants (PAs) and nurse practitioners (NPS) to use as a tool for the best patient modality to use in Treatment Resistant Depression (TRD).

Methods: Comparisons of both ECT and TMS began the early 2000s and is actively studied to the present day. A meta-analysis of two randomized, controlled studies and retrospective reviews were compared for efficacy in MDD treatment. Baseline score comparison of the Dutch versions of the Hamilton Depression Rating Scale (HAM-D), Beck Depression Scale (BDI-II), and the Remission from Depression Questionnaire (RDQ) were used to compare data and personalize treatment.

Results: Up to 30% of patients suffer from MDD. ECT use began in the 1960s and is used to present day with a success rate of 80-85%. TMS was introduced in 1985 also being used to the present day with an overall success rate of 50-60%. Though the success rate is significantly lagging, both PAs and NPs are recommending TMS treatment in favor of ECT due to adverse side effects and patient acceptance of treatment.

Conclusion: Providers overall are still exploring the use of both modalities, ECT and TMS. Providing up to date through various studies can help tailor the best treatment for each patient.


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