University of Lynchburg DMSc Doctoral Project Assignment Repository
Specialty
Behavioral Health
Advisor
Dr. N. Delis, DMSc, MS, PA-C
Abstract
ABSTRACT
Adults with treatment-resistant depression face long-term symptoms and significant dysfunction despite antidepressant therapy. This review analyzes the evidence from 2020 to 2025 on the effectiveness, tolerability, and practical application of transcranial magnetic stimulation (TMS) and electroconvulsive therapy (ECT). ECT is more effective in alleviating symptoms and inducing remission in severe or psychotic conditions; however, it has more cognitive side effects and necessitates anesthesia. Both treatments require maintenance sessions or adjunct pharmacotherapy. Recent forms of TMS, including theta burst stimulation, deep stimulation, and high-frequency schedules, increase flexibility and can reduce recovery time. To support evidence-based selection of neuromodulation in the treatment of adult treatment-resistant depression, clinicians may consider TMS as the initial neuromodulation procedure and use ECT in emergencies or TMS-unresponsive situations. Given TMS's safety profile, clinicians should consider initiating this treatment modality earlier in the treatment course for their patients.
Recommended Citation
Helwig-Henson M. Transcranial Magnetic Stimulation Versus Electroconvulsive Therapy for Adults with Treatment-Resistant Depression: A Clinical Review. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2025; 7(3).
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