Augmenting Antidepressants With Deep Transcranial Magnetic Stimulation (Deep TMS) in Treatment-Resistant Major Depression
Journal: World Journal of Biological Psychiatry 15(7):570-578 (2014)
Authors: M.T Berlim, F Van den Eynde, S Tovar-Perdomo, E Chachamovich, A Zangen, G Turecki
Background:
Deep transcranial magnetic stimulation (Deep TMS™) has been shown to be efficacious and relatively safe for major depressive disorder (MDD). However, its clinical utility as an augmenting strategy for treatment-resistant depression (TRD) remains unexplored.
Objective:
To evaluate the clinical utility of Deep TMS as an augmenting strategy for patients with TRD.
Methods:
in an open label trial, 17 outpatients with severe TRD received 4 weeks of daily high frequency Deep TMS over the left dorsolateral prefrontal cortex. Depressive and anxious symptoms, suicidality and quality of life (QOL) were measured at baseline (i.e., in the week prior to the start of the Deep TMS treatment) and at week 5 (i.e., in the week following the end of the Deep TMS treatment). Primary outcome measures were rates of response and remission at week 5 using an intention-to-treat approach.
Results:
Response and remission rates at week 5 were 70.6 and 41.2%, respectively. Also, depression, anxiety, and suicidality ratings were significantly improved by week 5 (with hedges’ g estimates ranging from 0.6 to 1.72), as well as four of the five QOL domain scores (i.e., global, psychological, environmental and social). Finally, two patients dropped out of the study at week 1 because of significant scalp discomfort during stimulation.
Conclusions:
This study suggests that Deep TMS, when used as an augmenting strategy for antidepressants in severe TRD, is efficacious, safe and relatively well tolerated. However, controlled studies with larger samples are needed to confirm and expand these preliminary findings.
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