title: Effectiveness of a second deep TMS in depression: a brief report.
abstract: OBJECTIVE
  Deep transcranial magnetic stimulation (DTMS) is an emerging and promising treatment for major depression. In our study, we explored the effectiveness of a second antidepressant course of deep TMS in major depression. We enrolled eight patients who had previously responded well to DTMS but relapsed within 1 year in order to evaluate whether a second course of DTMS would still be effective.
  
  
  METHODS
  Eight depressive patients who relapsed after a previous successful deep TMS course expressed their wish to be treated again. Upon their request, they were recruited and treated with 20 daily sessions of DTMS at 20 Hz using the Brainsway's H1 coil. The Hamilton depression rating scale (HDRS), Hamilton anxiety rating scale (HARS) and the Beck depression inventory (BDI) were used weekly to evaluate the response to treatment.
  
  
  RESULTS
  Similar to the results obtained in the first course of treatment, the second course of treatment (after relapse) induced significant reductions in HDRS, HARS and BDI scores, compared to the ratings measured prior to treatment. The magnitude of response in the second course was smaller relative to that obtained in the first course of treatment.
  
  
  CONCLUSIONS
  Our results suggest that depressive patients who previously responded well to deep TMS treatment are likely to respond again. However, the slight reduction in the magnitude of the response in the second treatment raises the question of whether tolerance or resistance to this treatment may eventually develop.
authors.affiliation: Beer Yaakov Mental Health Center affiliated to Sackler School of Medicine, University of Tel Aviv, Israel. oded.rosenberg@beerness.health.gov.il
authors.forename: O
authors.initials: O
authors.lastname: Rosenberg
authors.forename: M
authors.initials: M
authors.lastname: Isserles
authors.forename: Y
authors.initials: Y
authors.lastname: Levkovitz
authors.forename: M
authors.initials: M
authors.lastname: Kotler
authors.forename: A
authors.initials: A
authors.lastname: Zangen
authors.forename: P N
authors.initials: PN
authors.lastname: Dannon
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology / Q000628:therapy; D046690:Deep Brain Stimulation / Q000009:adverse effects; D003865:Major Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004574:Electromagnetic Fields; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D050781:Transcranial Magnetic Stimulation / Q000009:adverse effects; D016896:Treatment Outcome