Neurostimulation Methods in the Treatment of Depression: A Comparison of rTMS, tDCS, and Venlafaxine Using a Pooled Analysis of Two Studies.

MDD efficacy major depressive disorder rTMS repetitive transcranial magnetic stimulation tDCS transcranial direct-current stimulation treatment venlafaxine

Journal

Neuropsychiatric disease and treatment

ISSN: 1176-6328

Titre abrégé: Neuropsychiatr Dis Treat

Pays: New Zealand

ID NLM: 101240304

Informations de publication

Date de publication:
2021

Historique:

received: 22 01 2021

accepted: 13 04 2021

entrez: 7 6 2021

pubmed: 8 6 2021

medline: 8 6 2021

Statut: epublish

Résumé

There are no head-to-head studies comparing the antidepressant effect of transcranial direct current stimulation (tDCS) with repetitive transcranial magnetic stimulation (rTMS). This pooled analysis compared indirectly the antidepressant efficacy and acceptability of rTMS, tDCS, and the antidepressant venlafaxine (VNF) extended-release. The analysis (n=117, both patients with treatment-resistant depression (TRD) and non-TRD were included) examined pooled data from two 4-week, single-centered, two-armed, double-blind, randomized studies (EUDRACT n. 2005-000826-22 and EUDRACT n. 2015-001639-19). The antidepressant efficacy of right-sided low-frequency rTMS (n=29) vs VNF (n=31) and left-sided anodal tDCS (n=29) vs VNF (n=28) was evaluated. The primary outcome was a change in the Montgomery-Åsberg Depression Rating Scale (MADRS) score from baseline to the treatment endpoint at week 4. The response was defined as a ≥50% reduction in the MADRS score and remission as the MADRS score ≤10 points, both were calculated for the primary treatment endpoint at week 4. Mean change in total MADRS scores from baseline to week 4 was 7.0 (95% CI, 4.8-9.1) points in the rTMS group, 7.6 (95% CI, 5.5-9.8) in the tDCS group, and 8.9 (95% CI, 7.4-10.4) among patients in the VNF group, a non-significant difference (F(2111)=0.62, p=0.54). Similarly, neither the response rates nor remission rates for rTMS (response 31%; remission 17%), tDCS (24%, 17%), or VNF (41%; 27%) significantly differed among treatment groups ( Our current analysis found a comparable efficacy and acceptability in all three treatment modalities (rTMS, tDCS, and VNF) and clinical relevance for the acute treatment of major depressive disorder.

Sections du résumé

BACKGROUND BACKGROUND

METHODS METHODS

The analysis (n=117, both patients with treatment-resistant depression (TRD) and non-TRD were included) examined pooled data from two 4-week, single-centered, two-armed, double-blind, randomized studies (EUDRACT n. 2005-000826-22 and EUDRACT n. 2015-001639-19). The antidepressant efficacy of right-sided low-frequency rTMS (n=29) vs VNF (n=31) and left-sided anodal tDCS (n=29) vs VNF (n=28) was evaluated. The primary outcome was a change in the Montgomery-Åsberg Depression Rating Scale (MADRS) score from baseline to the treatment endpoint at week 4. The response was defined as a ≥50% reduction in the MADRS score and remission as the MADRS score ≤10 points, both were calculated for the primary treatment endpoint at week 4.

RESULTS RESULTS

Mean change in total MADRS scores from baseline to week 4 was 7.0 (95% CI, 4.8-9.1) points in the rTMS group, 7.6 (95% CI, 5.5-9.8) in the tDCS group, and 8.9 (95% CI, 7.4-10.4) among patients in the VNF group, a non-significant difference (F(2111)=0.62, p=0.54). Similarly, neither the response rates nor remission rates for rTMS (response 31%; remission 17%), tDCS (24%, 17%), or VNF (41%; 27%) significantly differed among treatment groups (

CONCLUSION CONCLUSIONS

Our current analysis found a comparable efficacy and acceptability in all three treatment modalities (rTMS, tDCS, and VNF) and clinical relevance for the acute treatment of major depressive disorder.

Identifiants

DOI: 10.2147/NDT.S303226 PMID: 34093015 PMC: PMC8169053

pubmed: 34093015

doi: 10.2147/NDT.S303226

pii: 303226

pmc: PMC8169053

doi:

Types de publication

Journal Article

Langues

eng

Pagination

1713-1722

Informations de copyright

Déclaration de conflit d'intérêts

Dr Tomas Novak reports personal fees from Krka ČR sro, outside the submitted work. The authors report no other conflicts of interest in this work.

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