Abstract
The efficacy of electroconvulsive therapy (ECT) is superior to that of repetitive transcranial magnetic stimulation (rTMS), particularly for the treatment of major depression with psychotic features. However, ECT is sometimes terminated for several reasons, including patient refusal. Here, the authors present the case of a 57-year-old woman who recovered from major depression with psychotic features with one course of rTMS after ECT was discontinued due to patient refusal. She had been suffering from depression with psychotic features (e. g., tactile hallucinations) for three years prior to admission. During the most recent episode, she was admitted to the authors' hospital and was eventually treated with one course of ECT; however, there was no change in her reported symptoms. Four weeks later, she refused a second course of ECT but agreed to a course of rTMS therapy. She demonstrated gradual recovery from depression three weeks after the initial rTMS therapy session. She demonstrated significant improvement and was discharged from the hospital after 55 days following the first rTMS session. Although the relationship between ECT and rTMS remains unclear, rTMS may be an option for major depression with psychotic features when the patient does not consent to continuing with ECT.
