Electroconvulsive Therapy and Transcranial Magnetic Stimulation

Compare and contrast ECT and TMS

In electroconvulsive therapy (ECT), direct electric current passed through the head of a sedated and immobilized patient to induce a therapeutic seizure, thereby resetting the brain (Magnezi et al., 2016). ECT is employed to treat severe and medication-resistant depression. On the other hand, transcranial magnetic stimulation creates magnetic fields that stimulate neurons in the brain to improve depression-related symptoms. Electromagnetic coil is put on the head of a patient to direct magnetic pulses into a region of the brain that controls moods (Purse, 2021). TMS is used to treat depressive patients who cannot tolerate medications because of side effects.

Both ECT and TMS improve the activity of nerve cells in the brain. They can be used to treat severe depression. However, TMS cannot be used to treat depressive patient with bipolar or suicide ideation. In addition, they increase the secretion of neurotransmitter chemicals that control the mood.

Differences: ECT is performed under general anesthesia in an operating room while this requirement is not needed in TMS, allowing the patient to stay awake during treatment. ECT uses electric currents to stimulate seizure in the brain while TMS uses magnetic pulses (Purse, 2021). ECT is an invasive procedure that causes seizure and is performed in operating room while TMS noninvasive procedure performed in the physician’s office.

In terms of advantages, both ECT and TMS are effective in treating patients with severe and medication-resistant depression or those who do not respond to TMS (Magnezi et al., 2016). Compared to ECT, TMS is however safe and well-tolerated with few side-effects. In addition, TMS allows patients to live independently while ECT does not.

Discuss n-acetylcysteine

Mechanisms of N-acetylcysteine (NAC) are not fully understood. However, NAC is believed to be a glutathione inducer and antioxidant indicated for treatment of acetaminophen overdose and mucolytic therapy (Giménez-Palomo et al., 2020). It is a precursor for the biosynthesis of glutathione. Promising results have found the efficacy of NAC in the treatment of depression in bipolar disorders and as an add-on treatment in cocaine and cannabis disorders (Dean, Giorlando, & Berk, 2011).

References

Magnezi R, et al. (2016). Comparison between neurostimulation techniques repetitive transcranial magnetic stimulation vs electroconvulsive therapy for the treatment of resistant depression: patient preference and cost-effectiveness. Patient Prefer Adherence, 10:1481-1487

Giménez-Palomo, A. et al. (2020). Exploring N-Acetylcysteine in Psychiatry. Psychiatric Times, 37(8). https://www.psychiatrictimes.com/view/exploring-n-acetylcysteine-in-psychiatry

Dean, O., Giorlando, F., & Berk, M. (2011). N-acetylcysteine in psychiatry: current therapeutic evidence and potential mechanisms of action. Journal of psychiatry & Neuroscience, JPN, 36(2), 78–86. https://doi.org/10.1503/jpn.100057

Purse, M. (2021). Transcranial Magnetic Stimulation vs. Electroconvulsive Therapy. Verywellmind. Retrieved on November 19, 2021 from https://www.verywellmind.com/transcranial-magnetic-stimulations-vs-ect-380646

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