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Decision Analysis of the Cost-Effectiveness of Repetitive Transcranial Magnetic Stimulation Versus Electroconvulsive Therapy for Treatment of Nonpsychotic Severe Depression

Published online by Cambridge University Press:  07 November 2014

F. Andrew Kozel ,
Mark S. George  and
Kit N. Simpson
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Abstract

Background: Repetitive transcranial magnetic stimulation (rTMS) is a new treatment with promise for resistant depression.

Objective: We tested the economic feasibility of this new method compared with electroconvulsive therapy (ECT).

Method: An economic decision analysis was used to compare the costs of three different treatment strategies for nonpsychotic severe depression. The strategies were: ECT alone; rTMS alone; and rTMS followed by ECT for nonresponders (rTMS-to-ECT). We calculated 12-month costs and quality adjusted life years (QALYs) for the three treatment options for all nonpsychotic, severely depressed United States patients who would have otherwise undergone ECT. A sensitivity analysis was performed to test the degree of change in outcome with various parameter changes.

Type
Original Research
Information
CNS Spectrums , Volume 9 , Issue 6 , June 2004 , pp. 476 - 482
Copyright
Copyright © Cambridge University Press 2004

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References

REFERENCES

1.Diagnostic and Statistical Manual of Mental Disorders. 4th ed–text rev. Washington, DC: American Psychiatric Association; 2000.Google Scholar
2.The Practice of Electroconvulsive Therapy: Recommendations for Treatment, Training, and Privileging. 2nd ed. Washington, DC: American Psychiatric Association; 2001.Google Scholar
3.George, MS, Wassermann, EM. Rapid-rate transcranial magnetic stimulation and ECT. Convuls Ther. 1994;10:251–253.Google ScholarPubMed
4.Little, JT, Kimbrell, TA, Wassermann, EM, et al.Cognitive effects of 1- and 20-hertz repetitive transcranial magnetic stimulation in depression: preliminary report. Neuropsychiatry Neuropsychol Behav Neurol. 2000;13:119–124.Google ScholarPubMed
5.George, MS, Belmaker, RH, eds. Transcranial Magnetic Stimulation in Neuropsychiatry. Washington, DC: American Psychiatric Association; 2000.Google Scholar
6.McNamara, B, Ray, JL, Arthurs, OJ, Boniface, S. Transcranial magnetic stimulation for depression and other psychiatric disorders. Psychol Med. 2001;31:1141–1146.CrossRefGoogle ScholarPubMed
7.Holtzheimer, PE 3rd, Russo, J, Avery, DH. A meta-analysis of repetitive transcranial magnetic stimulation in the treatment of depression. Psychopharmacol Bull. 2001;35:149–169.Google ScholarPubMed
8.Burt, T, Lisanby, SH, Sackeim, HA. Neuropsychiatric applications of transcranial magnetic stimulation. Int J Neuropsychopharmacol. 2002;5:73–103.CrossRefGoogle ScholarPubMed
9.Kozel, FA, George, MS. Meta-analysis of left prefrontal repetitive transcranial magnetic stimulation (rTMS) to treat depression. Journal of Psychiatric Practice. 2002;8:27O–275.CrossRefGoogle ScholarPubMed
10.Martin, JLR, Barbanoj, MJ, Schlaepfer, TE, et al.Transcranial magnetic stimulation for treating depression (Cochrane Review). In: The Cochrane Library. Oxford, England: Update Software; 2002;2.Google Scholar
11.Grunhaus, L, Dannon, PN, Schreiber, S, et al.Repetitive transcranial magnetic stimulation is as effective as electroconvulsive therapy in the treatment of nondelusional major depressive disorder: an open study. Biol Psychiatry. 2000;47:314–324.CrossRefGoogle ScholarPubMed
12.Pridmore, S, Bruno, R, Turnier-Shea, Y, Reid, P, Rybak, M. Comparison of unlimited numbers of rapid transcranial magnetic stimulation (rTMS) and ECT treatment sessions in major depressive episode. Int J Neuropsychopharmacol. 2000;3:129–134.CrossRefGoogle ScholarPubMed
13.Janicak, PG, Dowd, SM, Martis, B, et al.Repetitive transcranial magnetic stimulation versus electroconvulsive therapy for major depression: preliminary results of a randomized trial. Biol Psychiatry. 2002;51:659–667.CrossRefGoogle ScholarPubMed
14.Gagne, GG Jr, Furman, MJ, Carpenter, LL, Price, LH. Efficacy of continuation ECT and antidepressant drugs compared with long-term antidepressants alone in depressed patients. Am J Psychiatry. 2000;157:1960–1965.CrossRefGoogle ScholarPubMed
15.Li, X, Nahas, Z, Oliver, NC, et al.Initial results using left prefrontal rTMS as a maintenance treatment for bipolar depression [abstract]. Biol Psychiatry. 2001;49:36S.Google Scholar
16.U.S. Census Bureau, Census 2000. Quick tables—American factfinder. Available at: http://factfinder.census.gov/servlet/QTTable?ds_name=DEC_2000_SFl_Ugeo_id=01000USqr_name=DEC_2000_SFl_U_DPl. Accessed October 25, 2002.Google Scholar
17.Feeny, D, Furlong, W, Torrance, GW, et al.Multiattribute and single-attribute utility functions for the health utilities index mark 3 system. Med Care. 2002;40:113–128.CrossRefGoogle ScholarPubMed
18.Dannon, PN, Dolberg, OT, Schreiber, S, Grunhaus, L. Three and six-month outcome following courses of either ECT or rTMS in a population of severely depressed individuals—preliminary report. Biol Psychiatry. 2002;51:687–690.CrossRefGoogle ScholarPubMed
19.Gold, M, Seigel, J, Russell, L, et al.Cost-Effectiveness in Health and Medicine. New York, NY: Oxford University Press; 1996.CrossRefGoogle ScholarPubMed