Magnetic Seizure Therapy Rivals Electroconvulsive Therapy for Major Depression

Inducing seizures can reset the brain in cases of severe depression, but the cost to memory has always been high.

A large-scale trial led by researchers at the Center for Addiction and Mental Health (CAMH) and the University of California, San Diego School of Medicine has now confirmed that magnetic pulses are just as effective as electricity at triggering these seizures, but with far fewer cognitive side effects.

Improving brain stimulation for treatment-resistant depression

Major depressive disorder is a debilitating mental health condition, especially for the third of patients who do not respond to standard medications or talk therapy.

For these individuals, doctors often turn to brain stimulation. Electroconvulsive therapy (ECT) is often considered the most effective tool available. It works by inducing a brief seizure to reset brain activity; however, it comes with a high cost. Many patients fear the confusion and memory loss associated with the treatment.

“ECT is an effective treatment in patients with treatment-resistant depression, yet only 1% accept treatment,” said the authors of the latest study.

Magnetic seizure therapy (MST) has recently surfaced as a promising alternative. While ECT uses electricity, MST uses high-intensity magnetic pulses to trigger a therapeutic seizure. MST is 5–10 times more focused than traditional methods, allowing it to target the frontal cortex while sparing structures deeper in the brain linked to memory.

Until now, there hasn’t been a large-scale, rigorous trial to see if MST could match the power of the best available ECT methods. The latest study aimed to understand whether MST was just as good at clearing depression symptoms while being much gentler on the mind.

Evaluating results from the depression trial

The CREST-MST trial involved three academic centers in Canada and the United States. Researchers recruited 239 participants with an average age of 45. All suffered from severe, non-psychotic depression. Participants were randomly assigned to receive either MST or a modern version of ECT designed to minimize side effects.

In the MST group, 22.5% of patients reached full remission, compared to 27.8% in the ECT group. While a higher number of ECT patients reached remission, the difference fell within the acceptable margin to call the treatments comparable.

When looking at clinical responses, the groups were almost identical. Roughly 47% of those receiving MST saw a meaningful clinical response, compared to 48% for ECT. Both treatments were equally effective at reducing suicidal thoughts.

MST also showed a large advantage in safety, with only 3% of the MST group experiencing a decline in their autobiographical memory, compared with 17% of the ECT group who suffered memory worsening. MST also led to better results in verbal fluency and executive functioning and patients receiving MST also regained awareness much faster after each session than those treated with ECT.

Future implications for depression brain stimulation care

By showing that MST can match the efficacy of ECT without the collateral damage to memory, MST can be positioned to become a primary option for severe depression.

“This is a major milestone for the field,” said lead author Dr. Daniel Blumberger, the scientific director and co-chief at CAMH. “For decades, we’ve known that ECT is one of the most effective treatments for severe depression, but its cognitive side effects have limited its use. Our findings show that MST can deliver similar benefits with much less impact on memory, which could make this kind of treatment a more viable option for many people who need it.”

If people no longer have to choose between their mood and their memory, the 1% acceptance rate for seizure therapies could rise significantly.

“This study represents an important first step toward bringing MST into wider clinical use,” added corresponding author Dr. Zafiris Daskalakis, a psychiatrist and professor at the University of California, San Diego School of Medicine. “If approved and implemented more broadly, it could transform how we deliver brain stimulation therapies and significantly improve the patient experience.”

However, the authors emphasized the limitations of the study. Enrolment was stopped slightly early, and the participant group lacked diversity, with ~85% of people identifying as White.

Future work needs to focus on ensuring these benefits apply to all populations. Before MST becomes available at every local clinic, it will need formal regulatory approval and specialized training for healthcare providers.

However, the study provides the groundwork to show that MST offers a way to treat the most stubborn forms of depression while keeping the patient's cognitive health intact.

Reference: Blumberger DM, McClintock SM, Thorpe KE, et al. Confirmatory efficacy and safety trial of magnetic seizure therapy versus right unilateral ultra-brief electroconvulsive therapy in depression (CREST–MST): a randomised, double-blind, non-inferiority trial in Canada and the USA. Lancet Psychiatry. 2026;13(5):376-386. doi: 10.1016/S2215-0366(26)00060-X

This article is a rework of a press release issued by the Centre for Addiction and Mental Health. Material has been edited for length and content.