Deep Transcranial Magnetic Stimulation Combined With SSRIs Possibly Effective for Treatment-Resistant Depression
These results suggest that deep transcranial magnetic stimulation combined with selective serotonin reuptake inhibitors may be effective in assisting patients with treatment-resistant depression.
The efficacy of deep transcranial magnetic stimulation (dTMS) in combination with selective serotonin reuptake inhibitors (SSRIs) for the treatment of chronic depression is supported by results of a prospective cohort study published in the Journal of Affective Disorders.
Patients with major depression (n=34) who failed to respond during a 16-week double-blind placebo-controlled trial of dTMS were assigned to a 4-week course of SSRIs with thrice-weekly high-frequency dTMS. The SSRIs administered had been previously ineffective but well-tolerated by participants. Patients were evaluated for depressive symptoms at baseline and after 2 and 4 weeks of study treatment.
Characterized as at least a 50% reduction in Hamilton Depression Rating Scale scores, 12 (35.3%) patients achieved remission after 4 weeks of treatment. In addition, significant improvements were observed on the Clinical Global Impressions Scale-Severity and the Quick Inventory of Depressive Symptoms after both 2 and 4 weeks of treatment (P <.001 for all). The treatment course was well tolerated; headaches during or after treatment were the only reported adverse effect of dTMS (n=4).
Researchers noted that a potential carry-over effect from the prior dTMS trial could confound results. Still, these results suggest that dTMS combined with SSRIs may be effective in assisting patients with treatment-resistant depression.
Tendler A, Gersner R, Roth Y, Zangen A. Alternate day dTMS combined with SSRIs for chronic treatment resistant depression: A prospective multicenter study. J Affect Disord. 2018;240:130-136.