Objective To systematically review the effectiveness of repetitive transcranial magnetic stimulation (rTMS) versus modified electroconvulsive therapy (ECT) on efficacy of treating depression.Methods Pubmed,Embase,Web of science,Cochrane library,CNKI,WanFang Data and CBM were searched since the database establishment till March in 2017 for randomized controlled trials(RCTs) that compared the efficacy of rTMS and ECT on depression mainly by assessment of response rate,and the mean Hamilton Depression Rating Scale (HDRS) score and remission rate. The dropout rate was also analyzed. The meta-analysis was performed by using RevMan 5.3 software. Results Fourteen RCTs involving 671 patients were finally included. The results showed that there was no significant difference between two therapies on the response rate (OR=0.71,95% CI: 0.46-1.10, P=0.120), remission rate(OR=0.67,95%CI:0.39-1.15,P=0.140)and dropout rate(OR=0.48,95%CI:0.23-1.01,P=0.050).Subgroup analysis showed ECT was more effective on psychotic depression(OR=0.27,95% CI:0.12-0.60,P=0.001).Moreover, mean HDRS score after the ECT was significantly lower than rTMS treatment(MD=2.04,95%CI:0.58-3.50, P=0.006).Conclusion rTMS has the same efficacy and acceptability as ECT for depression treatment,and ECT seems to be advantageous on psychotic depression.

Objective To systematically review the effectiveness of repetitive transcranial magnetic stimulation (rTMS) versus modified electroconvulsive therapy (ECT) on efficacy of treating depression.Methods Pubmed,Embase,Web of science,Cochrane library,CNKI,WanFang Data and CBM were searched since the database establishment till March in 2017 for randomized controlled trials(RCTs) that compared the efficacy of rTMS and ECT on depression mainly by assessment of response rate,and the mean Hamilton Depression Rating Scale (HDRS) score and remission rate. The dropout rate was also analyzed. The meta-analysis was performed by using RevMan 5.3 software. Results Fourteen RCTs involving 671 patients were finally included. The results showed that there was no significant difference between two therapies on the response rate (OR=0.71,95% CI: 0.46-1.10, P=0.120), remission rate(OR=0.67,95%CI:0.39-1.15,P=0.140)and dropout rate(OR=0.48,95%CI:0.23-1.01,P=0.050).Subgroup analysis showed ECT was more effective on psychotic depression(OR=0.27,95% CI:0.12-0.60,P=0.001).Moreover, mean HDRS score after the ECT was significantly lower than rTMS treatment(MD=2.04,95%CI:0.58-3.50, P=0.006).Conclusion rTMS has the same efficacy and acceptability as ECT for depression treatment,and ECT seems to be advantageous on psychotic depression.