High frequency repetitive transcranial magnetic stimulation as an augmenting strategy in severe treatment-resistant major depression: a prospective 4-week naturalistic trial.
BACKGROUND
Randomized, controlled trials (RCTs) have found repetitive transcranial magnetic stimulation (rTMS) to be effective for major depression, but its usefulness as an augmenting strategy for severe treatment-resistant depression (TRD) has yet to be firmly established.


METHODS
In a naturalistic trial, 15 chronically depressed, severely treatment-resistant patients were treated with daily high frequency (HF) rTMS over the left dorsolateral prefrontal cortex (DLPFC) for 4 weeks as an augmenting strategy. Depressive and anxious symptoms (both subjective and objective), as well as quality of life (QOL) domains were measured pre-post rTMS treatment.


RESULTS
Pre-post rTMS comparisons revealed significant reductions of both clinician-rated and selfreport depression and anxiety measures and increases in three (out of five) domains of subjective QOL (i.e., global, physical, and psychological).


CONCLUSIONS
Small sample size and non-controlled design.


CONCLUSIONS
Our results suggest that HF rTMS, when used as an augmenting strategy, positively affects depressive and anxious symptoms as well as QOL in patients with severe TRD. However, further studies with larger samples and controlled designs are needed to better clarify our preliminary findings.
Depressive Disorders Program, Douglas Mental Health University Institute and McGill University, Montréal, Québec, Canada. mtberlim@gmail.com
Marcelo T
MT
Berlim
Alexander
A
McGirr
Marie-Martine
MM
Beaulieu
Gustavo
G
Turecki
D000928:Antidepressive Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017397:Prefrontal Cortex; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology; D050781:Transcranial Magnetic Stimulation / Q000379:methods; D017211:Treatment Failure; D016896:Treatment Outcome
D000928:Antidepressive Agents