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Alternate day dTMS combined with SSRIs for chronic treatment resistant depression: A prospective multicenter study
- Source :
- Journal of Affective Disorders. 240:130-136
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Chronic treatment resistant depression takes a substantial toll on patients' quality of life and alternative treatment options are limited. This prospective multicenter study evaluated the safety, tolerability and efficacy of four weeks of thrice-a-week deep transcranial magnetic stimulation (dTMS) in combination with selective serotonin reuptake inhibitors (SSRIs).Forty patients who failed to respond during a 16-week double-blind placebo controlled (DBPC) trial of dTMS or sham dTMS as monotherapy were screened and started a treatment of previously tolerable but ineffective SSRI. After ten days of medication, high frequency dTMS was added three times a week for four weeks.dTMS combined with SSRIs was well tolerated, with only headaches as a related adverse event (n = 4), which did not cause drop outs. Six patients were excluded from analysis: 1 was missing screening data and 5 received less than 10 sessions. Out of 34 patients included in this study, 12 (35.3%) patients remitted (HDRS-21 10). No significant differences were found between patients who had received sham or active dTMS in the earlier DBPC multicenter trial.This was a small scale open study of dTMS with SSRIs in patients that failed to respond during a DBPC dTMS trial, although a carryover effect cannot be excluded. Comparative efficacy of dTMS with and without SSRIs and specific dosing and protocol parameters warrant specifically-designed large-scale controlled studies.Thrice weekly dTMS at 120% motor threshold(MT), 10 HZ, 3‑s trains, 20‑s intervals, 2400 daily pulses, can augment formerly ineffective SSRI treatment.
- Subjects :
- Adult
Male
medicine.medical_specialty
Placebo
Depressive Disorder, Treatment-Resistant
Young Adult
03 medical and health sciences
0302 clinical medicine
Quality of life
Internal medicine
medicine
Humans
Prospective Studies
Dosing
Deep transcranial magnetic stimulation
Adverse effect
Aged
business.industry
Middle Aged
medicine.disease
Combined Modality Therapy
Transcranial Magnetic Stimulation
030227 psychiatry
Psychiatry and Mental health
Clinical Psychology
Treatment Outcome
Tolerability
Female
Headaches
medicine.symptom
business
Treatment-resistant depression
Selective Serotonin Reuptake Inhibitors
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 01650327
- Volume :
- 240
- Database :
- OpenAIRE
- Journal :
- Journal of Affective Disorders
- Accession number :
- edsair.doi.dedup.....5dbee3ba3f0bc5c7a6f4e1d71fccd53b