A 3-month, follow-up, randomized, placebo-controlled study of repetitive transcranial magnetic stimulation in depression.
OBJECTIVE
There is evidence for an antidepressant effect of repetitive transcranial magnetic stimulation (rTMS), but little is known about posttreatment course. Therefore, we conducted a placebo-controlled, double-blind study in depressed patients in order to investigate the effect of rTMS on depression over 12 weeks after completion of the 2-week stimulation period.


METHODS
55 patients with a moderate or severe DSM-IV major depressive episode were randomly assigned to rTMS or sham treatment. rTMS was given daily for 10 days over the left dorsolateral prefrontal cortex with the following treatment parameters: 20 Hz, 20 trains of 2 seconds, 30 seconds between trains, and 80% motor threshold. The effect of rTMS on depression was rated repeatedly with the 17-item Hamilton Rating Scale for Depression (HAM-D) during the 2-week period of stimulation and the 12-week follow-up period conducted from 1997 to 2001.


RESULTS
We found a modest, clinically nonrelevant decrease in HAM-D scores in both rTMS and sham patients over 2 weeks of treatment. However, over the subsequent 12-week follow-up, the rTMS group continued to improve significantly compared with the placebo group.


CONCLUSIONS
Decrease of depressive symptoms may continue after the cessation of rTMS stimulation.
Koerselman
Frank
F
Department of Psychiatry, St. Lucas Andreas Hospital, Amsterdam, The Netherlands. f.koerselman@slaz.nl
Laman
D Martin
DM
van Duijn
Hans
H
van Duijn
Marijtje A J
MA
Willems
Martin A M
MA
D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D004311:Double-Blind Method; D004565:Electroconvulsive Therapy; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010352:Patient Dropouts; D010554:Personality Disorders / Q000453:epidemiology; D010919:Placebos; D017397:Prefrontal Cortex / Q000502:physiology*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011619:Psychotropic Drugs / Q000627:therapeutic use; D050781:Transcranial Magnetic Stimulation / Q000627:therapeutic use*; D016896:Treatment Outcome
D010919:Placebos; D011619:Psychotropic Drugs