Table HSummary of findings on nonpharmacologic treatment of adult treatment-resistant depression (TRD) with strength of evidence for Tier 1 (TRD) for KQ 4d, adherence as measured by overall withdrawals

ComparisonOutcomeNumber of SubjectsStrength of Evidence*Findings†
ECT vs. rTMSOverall withdrawals72Low1 fair trial and 1 fair cohort study: studies showed more withdrawals in the ECT group compared with rTMS (P = NR).
ECT vs. shamOverall withdrawals0NANo eligible studies identified. ‡
rTMS vs. shamOverall withdrawals325Insufficient8 fair trials: trials showed mixed results about withdrawals.
CBT vs. usual careOverall withdrawals0NANo eligible studies identified. ‡

CBT = cognitive behavioral therapy; ECT = electroconvulsive therapy; NA = not applicable; 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.

‡

At least one Tier 2 and/or Tier 3 study addressed this comparison.

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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