ReviewNigerian medical journal : journal of the Nigeria Medical Association
Comparative Efficacies of Electroconvulsive Therapy (ECT) and Repetitive Transcranial Magnetic Stimulation (rTMS) in Treatment-Resistant Depression: A Randomized Controlled Trial in Nigeria.
Review in Nigerian medical journal : journal of the Nigeria Medical Association. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
4 authors.
Funding
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Abstract
Background: Treatment-resistant depression (TRD) poses significant challenges globally, particularly in low-resource settings. While electroconvulsive therapy (ECT) remains the standard for TRD, repetitive transcranial magnetic stimulation (rTMS) offers a non-invasive alternative. This study compared short- and long-term efficacy and safety of ECT versus rTMS among Nigerian patients with TRD. Methodology: In a randomized, rater-blinded trial, 40 adults with TRD received either ECT (n=20; bilateral, twice weekly for 3 weeks) or high-frequency rTMS (n=20; left dorsolateral prefrontal cortex, 3000 pulses/session, 5 sessions/week for 6 weeks). Depression severity (HAM-D) was assessed at baseline, weeks 2, 4, 6, and at 6 and 12 months. Results: Both interventions significantly reduced HAM-D scores (p<0.001). ECT showed faster early improvement (Week 4: ECT=10.30±2.84, rTMS=12.25±2.99; p<0.001), with comparable outcomes at Week 6 (ECT=4.30±2.23, rTMS=4.40±2.35; p=0.89). However, rTMS demonstrated superior long-term control at 6 months (4.05±2.11 vs. 6.60±2.97; p<0.001) and 12 months (5.25±2.89 vs. 10.55±3.45; p<0.001). Remission rates at 12 months were 65% for rTMS versus 20% for ECT. Adverse events, particularly cognitive impairment, were more frequent with ECT (60% vs. 0%; p<0.001). Conclusion: While ECT provides faster acute symptom relief, rTMS offers superior sustained benefits with fewer adverse effects, suggesting its potential as a first-line neurostimulation for TRD in resource-constrained settings. Larger studies with cost-effectiveness analyses are warranted.
Indexed as
Identifiers
42605373PMC13477706What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.