Philip, N. S., Dunner, D. L., Dowd, S. M., Aaronson, S. T., Brock, D. G., Carpenter, L. L., … & George, M. S. (2016). Can medication free, treatment-resistant, depressed patients who initially respond to TMS be maintained off medications? A prospective, 12-month multisite randomized pilot study. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation, 9(2), 251-257.
This 12-month study examined whether monthly rTMS treatments were more effective than observation only in maintaining treatment response to rTMS therapy in non-medicated patients with MDD. Response to the initial 6 weeks of rTMS treatment was classified as scoring less than 15 on the 17-Item Hamilton Rating Scale for Depression (HAMD17) and an overall score reduction greater than 25% compared to pre-treatment. 73% (49/67) of patients responded to initial rTMS treatment and were then randomized to receive either monthly rTMS or monthly observational visits with no rTMS. Either group were eligible for the reintroduction of rTMS treatment in response to symptoms recurrence. The authors observed no statistically significant difference in outcomes between both maintenance strategies. However, those with monthly rTMS had slightly longer duration to relapse (91 vs 77 days), were slightly less likely to need reintroduction of treatment (35% vs 39%), and on reintroduction of treatment required slightly fewer treatments (14.3 vs 16.9). The authors concluded that scheduled maintenance therapy is not significantly more effective at preventing relapse compared to reintroducing rTMS on symptom recurrence. However, they also suggest a more scheduled approach to rTMS maintenance therapy may be beneficial after the initial recurrence of symptoms.
*For original abstract/publication see the link below.
Publication link: Can Medication Free, Treatment-Resistant, Depressed Patients Who Initially Respond to TMS Be Maintained Off Medications? A Prospective, 12-Month Multisite Randomized Pilot Study – ScienceDirect