Study Comparing Magnetic Seizure Therapy (MST) to Electroconvulsive Therapy (ECT) for Depression in Older Adults

Inclusion Criteria:

• Age 55-90

• Clinical diagnosis of major depressive episode, in the context of unipolar or bipolardisorder

• Willing and capable to provide informed consent

• Convulsive therapy clinically indicated

• Hamilton Rating Scale for Depression (HRSD24)≥ 20

• Mini Mental State Exam (MMSE) ≥ 24

• For outpatients: responsible adult living with the patient

Exclusion Criteria:

• Current unstable or serious medical condition, or any comorbid medical condition thatsubstantially increases the risks of ECT (such as acute myocardial infarction, spaceoccupying brain lesion or other cause of increased intracranial pressure, unstableaneurysm or vascular malformation, poorly controlled diabetes mellitus, carcinoma,renal failure, hepatic failure)

• History of neurological disorder, epilepsy, stroke, brain surgery, metal in the head,history of known structural brain lesion

• Presence of devices that may be affected by MST (pacemaker, medication pump, cochlearimplant, implanted brain stimulator, or vagus nerve stimulator implanted)

• History of head trauma with loss of consciousness for greater than 5 minutes

• History of schizophrenia, schizoaffective disorder, or rapid cycling bipolar disorder

• History of substance abuse or dependence in past 3 months

• Failure to respond to an adequate course of ECT in the current depressive episode

• History of ECT in the past 6 months and/or failure to respond to an adequate trial ofECT lifetime

• Presence of intracardiac lines