Magnetic seizure therapy

Domain IX · Biomedical, neuro & digital · Harold Sackeim, Sarah H. Lisanby, Thomas Schlaepfer · 1990 · Columbia University, USA; first treatment in Bern, Switzerland

What it is

MST is an investigational convulsive therapy. Like ECT, it deliberately induces a therapeutic seizure under general anaesthesia; unlike ECT, the seizure is triggered with rapidly repeated magnetic pulses rather than an electrical current passed through the scalp. The rationale its developers give…

Format

• Stage B: Screening and consent. The trial team does a health history, physical examination, vital signs, blood tests, ECG, diagnostic interview and depression ratings; baseline includes interviews, questionnaires and about 1.5 hours of cognitive testing. An attending ECT/MST psychiatrist judges…
• Stage C: Acute course. Randomisation (in comparison trials, to MST or ECT, with client and raters blind to arm; both devices may be in the room to keep the blind); each treatment under general anaesthesia with muscle relaxation and EEG seizure monitoring, a short treatment followed by recovery;…

Who practises it, and how they are trained or regulated

• Regulatory status (as of October 2026).
• Evidence status (descriptive, as sources report). CREST-MST was a randomised, double-blind, non-inferiority trial at three academic centres in Canada and the USA (Toronto, Dallas, San Diego) in adults with non-psychotic depression. Of 292 people enrolled, 239 were randomised. Three withdrew before treatment, so 236 were analysed (119 ECT, 117 MST). Reports giving 236 or 239 are therefore counting analysed versus…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• distress about blinding; feeling like "a test subject".
• pinning all hope on acceptance; financial or travel strain.
• suicidal crisis needing urgent rather than routine review (see B8).
• expecting the treatment alone to resolve long-standing difficulties.
• any of the above reported to you between visits; pass it on (see B7).

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.