Table ESummary of findings on nonpharmacologic treatment of adult treatment-resistant depression (TRD) with strength of evidence for Tier 1 (TRD) for KQ 4a, impact of nonpharmacologic interventions on cognitive functioning

ComparisonOutcomeNumber of SubjectsStrength of Evidence*Findings†
ECT vs. rTMSCognitive functioning72Insufficient1 fair trial and 1 fair cohort study: Some evidence suggests no difference between treatments, whereas some evidence suggests ECT may have deleterious impact on cognitive functioning compared with rTMS (1 study: significant effect on 1-week recall; both studies: nonsignificant effect on all other measures).
ECT vs. ECT + rTMSCognitive functioning22Insufficient1 fair trial: no significant differences in a single item measure on memory problems.
rTMS vs. shamCognitive functioning161Insufficient4 trials (1 good, 3 fair): Some evidence suggests no difference between rTMS and sham, whereas some evidence suggests that rTMS improves cognitive functioning compared to sham (2 trials: significant differences in memory, verbal fluency; all other findings nonsignificant or significance not reported).

ECT = electroconvulsive therapy; rTMS = repetitive transcranial magnetic stimulation; vs. = versus

*

Strength of evidence is based on guidance provided in the AHRQ Methods Guide for Comparative Effectiveness Reviews; see text.

†

Good and fair designations relate to quality ratings for each study.

From: Executive Summary

Cover of Nonpharmacologic Interventions for Treatment-Resistant Depression in Adults
Nonpharmacologic Interventions for Treatment-Resistant Depression in Adults [Internet].
Comparative Effectiveness Reviews, No. 33.
Gaynes BN, Lux LJ, Lloyd SW, et al.
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