Intensive rTMS for treatment-resistant depression patients with suicidal ideation: An open-label study.
Depression
Intensive
Repetitive transcranial magnetic stimulation
Suicidal ideation
Treatment-resistant depression
Journal
Asian journal of psychiatry
ISSN: 1876-2026
Titre abrégé: Asian J Psychiatr
Pays: Netherlands
ID NLM: 101517820
Informations de publication
Date de publication:
Aug 2022
Aug 2022
Historique:
received:
12
02
2022
revised:
04
05
2022
accepted:
13
06
2022
pubmed:
22
6
2022
medline:
22
7
2022
entrez:
21
6
2022
Statut:
ppublish
Résumé
The advantages of intensive repetitive transcranial magnetic stimulation (rTMS) protocol are in the possible acute effect of the stimulation and in the possible reduction in the time required to achieve remission in depression. Here, we investigated the antidepressant effects and antisuicidal effects of a more intensive rTMS protocol for treatment-resistant depression (TRD) patients with suicidal ideation. Thirty-one outpatients were included in this study, including 22 military veterans and 9 non- militaries. The rTMS treatment consisted of 25 sessions, each session lasting 30 min (60 trains of 50 pulsations, 110 % resting motor threshold intensity) for a total of 3000 pulse. The total amount of stimulation (750,000 pulses) applied by our rTMS protocol was equivalent to that of a 5-week standard rTMS protocol. We found a significant effect of time on the 17-item Hamilton Depression Rating Scale (HAMD-17) scores and the Sheehan Disability Scale (SDS) scores. There was no difference in change in the HAMD-17 scores and SDS scores between the military veteran group and the non-military group between baseline and the week 4 assessment time point. The response rate of depression was 64.52 %, and the remission rate of depression was 51.61 % at day 5. 48.39 % and 35.48 % at week 4, respectively. All patients (100 %) met response criteria of suicidal ideation, and the remission rate was 87.09 % at day 5. The response rate was 83.87 % %, and the remission rate was 77.42 % at week 4. The accelerated high-dose rTMS treatment was well tolerated by all patients. Our intensive rTMS protocol is preliminarily safe and feasible. The TRD patients with suicidal ideation could benefit from much shorter exposure to this protocol with more efficacy in comparison with conventional rTMS protocol. In addition, intensive rTMS offers a promising treatment for military veteran populations.
Identifiants
pubmed: 35728457
pii: S1876-2018(22)00187-3
doi: 10.1016/j.ajp.2022.103189
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
103189Informations de copyright
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