Transcranial magnetic stimulation (tms) for major depression
Depression and Anxiety, 06/12/2012
Carpenter LL et al. – Outcomes demonstrated response and adherence rates similar to research populations. These data indicate that transcranial magnetic stimulation is an effective treatment for those unable to benefit from initial antidepressant medication.Methods
- Forty-two US-based clinical TMS practice sites treated 307 outpatients with Major Depressive Disorder (MDD), and persistent symptoms despite antidepressant pharmacotherapy.
- Treatment was based on the labeled procedures of the approved TMS device.
- Assessments were performed at baseline, week 2, at the point of maximal acute benefit, and at week 6 when the acute course extended beyond 6 weeks.
- The primary outcome was change in the Clinician Global Impressions-Severity of Illness from baseline to end of acute phase.
- Secondary outcomes were change in continuous and categorical outcomes on self-report depression scales (9-Item Patient Health Questionnaire [PHQ-9], and Inventory of Depressive Symptoms-Self Report [IDS-SR]).
- Patients had a mean ± SD age of 48.6 ± 14.2 years and 66.8% were female.
- Patients received an average of 2.5 (± 2.4) antidepressant treatments of adequate dose and duration without satisfactory improvement in this episode.
- There was a significant change in CGI-S from baseline to end of treatment (-1.9 ± 1.4, P < .0001).
- Clinician-assessed response rate (CGI-S) was 58.0% and remission rate was 37.1%.
- Patient-reported response rate ranged from 56.4 to 41.5% and remission rate ranged from 28.7 to 26.5%, (PHQ-9 and IDS-SR, respectively).