Bipolar disorder: is magnetic seizure therapy a treatment option?

In the randomised study, participants were treated either with magnetic seizure therapy (MST) or with Electroconvulsive Therapy (ECT). What were the results?

Electroconvulsive therapy vs. magnetic seizure therapy for bipolar disorder: The key issues

Symptoms reduction, as determined using the Young Manic Rating Scale, was roughly the same in both groups.
There were significantly fewer speech disorders in the MST group than in the ECT arm.
Neither of the two therapies resulted in serious adverse effects.

ECT – why move away from it?

Electroconvulsive therapy (ECT) is still highly valued in psychiatry today. And not without reason. For many patients with psychiatric disorders, the convulsive therapy is a good treatment option when other forms of therapy have not led to the desired success.

But like any other medical intervention, ECT has side effects, such as cognitive or speech disorders. It is therefore not surprising that alternatives to this effective form of treatment are being sought.

What is magnetic seizure therapy?

One candidate for this is magnetic seizure therapy. Unlike ECT, magnetic seizure therapy does not use electrical impulses but magnetic waves to trigger seizures. As a rule, these are more localised and milder than with ECT.

To induce a seizure, a magnetic coil is placed on the patient's head, usually over the frontal cortex. In the present study, the vertex was stimulated at 75 Hz.

Which works better: electrical impulses or magnetic waves?

After eight to ten treatments with either ECT or MST, the participants' data were analysed. The result showed that both measures led to a good reduction of symptoms (based on the Young Manic Rating Scale) with no significant differences in the two groups. Also, there were no significant side effects in either of the two therapy arms.

However, there was one significant difference: patients who received MST were less likely to experience speech disorders than those in the ECT group.

Conclusion for medical practice

Both ECT and MST are good treatment options for people with bipolar disorder. However, the data suggest that cognitive disorders may occur significantly less frequently when treated with magnetic waves than when treated with electrical impulses.

Sources

Chen S, Sheng J, Yang F, et al. Magnetic Seizure Therapy vs Modified Electroconvulsive Therapy in Patients With Bipolar Mania: A Randomized Clinical Trial. JAMA Netw Open. 2024;7(4):e247919. doi:10.1001/jamanetworkopen.2024.7919