Transcranial Magnetic Stimulation Eases Depression

A new study confirms that transcranial magnetic stimulation (TMS) is an effective treatment for patients with depression who are unable to find symptom relief through antidepressant medications.

Researchers at Butler Hospital (Providence, RI, USA) conducted a naturalistic review of 307 outpatients (mean ages 48.6, 66.8% female) with major depressive disorder (MDD) and persistent symptoms despite antidepressant pharmacotherapy, treated at 42 clinical TMS practice sites across the United States. Assessments were performed at baseline, week two, at the point of maximal acute benefit, and at week six, 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 self-reported changes in continuous and categorical outcomes of depression scales.

The researchers found that patients received an average of 2.5 antidepressant treatments of adequate dose and duration (without satisfactory improvement) in this episode. TMS demonstrated a significant change in clinician-assessed response rate (CGI-S) from baseline to end of treatment (58%), and a remission rate of 37.1%. Patient-reported response rate ranged from 56.4 to 41.5% and remission rate ranged from 28.7 to 26.5%. According to the researchers, the data validates TMS efficacy in treating depression for those who have failed to benefit from antidepressant medications. The study was published online in the June 11, 2012, edition of Depression and Anxiety.

“The patient outcomes we found in this study demonstrated a response rate similar to controlled clinical trial populations,” said lead author Linda Carpenter, MD, chief of the mood disorders program and the neuromodulation clinic at Butler Hospital. “Continued research and confirmation of the effectiveness of TMS is important for understanding its place in everyday psychiatric care and to support advocacy for insurance coverage of the treatment.”

TMS is a noninvasive method that uses electromagnetic induction to stimulate weak electric currents in the brain, causing depolarization or hyperpolarization in neurons. Studies of the use of TMS to treat many neurological and psychiatric conditions have generally shown only modest effects with little confirmation of results, but appear to be effective in the treatment of certain types of major depression, under certain specific conditions.

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