Premium
Accelerated repetitive transcranial magnetic stimulation for treatment‐resistant depression
Author(s) -
Holtzheimer Paul E.,
McDonald William M.,
Mufti Mustafa,
Kelley Mary E.,
Quinn Sinéad,
Corso German,
Epstein Charles M.
Publication year - 2010
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/da.20731
Subject(s) - transcranial magnetic stimulation , depression (economics) , anxiety , adverse effect , medicine , antidepressant , suicidal ideation , open label , stimulation , psychology , anesthesia , psychiatry , poison control , injury prevention , emergency medicine , economics , macroeconomics
Background : Repetitive transcranial magnetic stimulation (rTMS) has shown safety and efficacy for treatment‐resistant depression, but requires daily treatment for 4–6 weeks. Accelerated TMS, with all treatments delivered over a few days, would have significant advantages in terms of access and patient acceptance. Methods : Open‐label accelerated TMS (aTMS), consisting of 15 rTMS sessions administered over 2 days, was tested in 14 depressed patients not responding to at least one antidepressant medication. Effects on depression, anxiety, and cognition were assessed the day following treatment, then after 3 and 6 weeks. Results : No seizure activity was observed and only one patient had a serious adverse event (increased suicidal ideation). Two patients failed to complete a full course of aTMS treatments, and 36% did not complete all study visits. Depression and anxiety significantly decreased following aTMS treatments and improvements persisted 3 and 6 weeks later. Response rates immediately following treatment and at 3 and 6 weeks were 43, 36, and 36%, respectively. Remission rates at the same timepoints were 29, 36, and 29%. Conclusions : Accelerated TMS demonstrated an excellent safety profile with efficacy comparable to that achieved in daily rTMS in other trials. Limitations primarily include open‐label treatment and a small sample size. Depression and Anxiety, 2010. © 2010 Wiley‐Liss, Inc.