Electroconvulsive therapy (ECT) remains one of the most effective treatments for severe depression, but it can cause memory and concentration difficulties for some people. Magnetic seizure therapy (MST) is a newer approach designed to trigger a therapeutic seizure with more focused stimulation, in the hope of achieving similar benefits with fewer cognitive effects.
A randomised clinical trial by Deng et al. compared MST with a modern, safer form of ECT (ultrabrief pulse right unilateral ECT) in 73 adults experiencing a major depressive episode. Participants were assigned by chance to one treatment or the other, then followed for up to six months to see how well the benefits held.
Response and remission rates were similar between the two treatments, and improvements were sustained over the follow-up period. Reaching remission took more sessions on average with MST than with ECT: 9.0 compared with 6.7. After treatment, people who received ECT took longer to become oriented again and reported more severe physical and cognitive side effects than those who received MST.
The findings suggest MST may offer antidepressant effects similar to ECT, with fewer of the side effects that can make ECT difficult to tolerate. ECT and MST are medical treatments provided by psychiatrists rather than by our psychologists at Gecko House. If depression is affecting your life, though, a psychologist or GP can talk through what kind of support might help.
Background: how ECT and MST work
Electroconvulsive therapy treats severe depression by using an electrical current to deliberately trigger a brief generalised seizure under general anaesthesia. It is among the most effective treatments available for severe depressive episodes. The electrical current also spreads through the brain in ways that can disrupt memory and thinking, particularly around the time of treatment. Ultrabrief pulse right unilateral ECT is a modern, gentler form that uses very short electrical pulses on one side of the head, and is currently considered the safest version available.
Magnetic seizure therapy is an experimental alternative. It uses a magnetic field rather than an electrical current to induce a seizure. Because magnetic fields can be aimed more precisely, a property described as focality, and because MST uses a weaker stimulation strength than standard ECT, researchers have theorised it might trigger fewer of the deeper brain effects linked to memory problems while still producing the therapeutic seizure thought to drive recovery.
What this study did
Deng and colleagues conducted a double-blinded randomised clinical trial, a design in which neither participants nor assessors know who received which treatment, reducing bias. It ran across three academic hospitals between 2007 and 2012. Adults aged 18 to 90 who had been referred for ECT for a major depressive episode, within either major depressive disorder or bipolar disorder, and who scored at least 18 on the 24-item Hamilton Depression Rating Scale, a clinician-rated measure of severity, were randomly assigned to MST or ultrabrief right unilateral ECT.
MST was given at a fixed high setting of 100 Hz at full device power for 10 seconds, while ECT was dosed relative to each person's individual seizure threshold. Depression was tracked using the same rating scale, with response defined as at least a 50% symptom reduction and remission as at least a 60% reduction plus a very low final score. Participants were then followed for up to six months to see whether improvements lasted.
What it found
Of 73 participants, 35 receiving MST and 38 receiving ECT, with 53 completing the full course, both treatments produced clinically meaningful improvement. Response and remission rates were similar between groups whether the analysis included everyone randomised or only those who completed treatment, and that held across the six-month follow-up. Neither treatment showed a significant overall advantage in effectiveness or durability.
One clear difference emerged. People receiving MST needed more sessions to reach remission on average, about 9, than those receiving ECT, about 7. ECT was linked to significantly longer time to become reoriented after each session, and participants reported more severe side effects overall, particularly physical and cognitive ones.
Why it matters, and its limits
The trial suggests MST can match the effectiveness of even the gentlest current form of ECT while potentially causing fewer side effects, which is an encouraging step for a treatment still under investigation. The sample size, though larger than earlier MST trials, remains modest, so smaller true differences between treatments might not have been detectable. The data were also gathered more than a decade ago, and MST remains investigational rather than routinely available.
If depression is affecting you or someone you care about, a psychologist, GP or psychiatrist can discuss which treatment options might suit your situation.