Long-term maintenance therapy for major depressive disorder with rTMS.
OBJECTIVE
There is growing evidence to support the short-term antidepressant effects of repetitive transcranial magnetic stimulation (rTMS), but few published data pertain to the maintenance treatment of patients with DSM-IV-diagnosed major depressive disorder who have responded acutely to rTMS. We describe long-term maintenance therapy for major depressive disorder with rTMS.


METHODS
Repetitive transcranial magnetic stimulation was applied in 10 adults over the left prefrontal cortex at 100% of motor threshold, most often at a frequency of 10 Hz for sessions consisting of 40 trains at 5 seconds per train (2000 pulses per session), for periods ranging from 6 months to 6 years. Session frequency averaged 1 to 2 per week. The study was conducted in the TMS lab of an academic medical center.


RESULTS
Seven of the 10 subjects experienced either marked or moderate benefit, which was sustained without the addition of concomitant antidepressant medication in 3 cases. There were no serious adverse events reported by any participant. The seizure rate for the 1831 reported rTMS sessions was zero.


CONCLUSIONS
These data, while open label, suggest that maintenance rTMS may be a safe and effective treatment modality in some patients with unipolar depression. Further research into the long-term safety and efficacy of rTMS is warranted.
O'Reardon
John P
JP
Department of Psychiatry, University of Pennsylvania, Ste. 4005, 3535 Market Street, Philadelphia, PA 19104, USA. oreardon@mail.med.upenn.edu
Blumner
Kate H
KH
Peshek
Andrew D
AD
Pradilla
Rocio Romero
RR
Pimiento
Pilar Cristancho
PC
D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000517:prevention & control* / Q000523:psychology / Q000628:therapy; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008134:Long-Term Care; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000502:physiology; D050781:Transcranial Magnetic Stimulation / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
D000928:Antidepressive Agents