title: Transcranial magnetic stimulation for treating depression in elderly patients.
abstract: OBJECTIVE
  The aim of the study reported here was to examine the safety and effectiveness of high-frequency repetitive transcranial magnetic stimulation (rTMS) in elderly patients with depression.
  
  
  METHODS
  Sixty-five depressed elderly patients received rTMS over their left prefrontal cortex for 6 days per week, from Monday to Saturday, for 3 weeks. The rTMS intensity was set at 100% of the motor threshold and 25 Hz stimulation with a duration of 2 seconds and was delivered 20 times at 30-second intervals. A full course comprised an average of 1000 magnetic pulses. Depression was rated using the Hamilton Depression Rating Scale (HAMD) before and after treatment. Response was defined as a 50% reduction in HAMD score. Patients with HAMD scores < 8 were considered to be in remission.
  
  
  RESULTS
  The mean HAMD score for the study group decreased from 21.94 ± 5.12 before treatment to 11.28 ± 4.56 after rTMS (P < 0.001). Following the treatment period, 58.46% of the study group demonstrated significant mood improvement, as indexed by a reduction of more than 50% on the HAMD score. Nineteen of these 38 patients attained remission (HAMD score < 8), while 41.54% of all study patients achieved a partial response. None of the patients had a worsened HAMD score at the end of the treatment. Treatment was generally well tolerated and no serious adverse effects were reported.
  
  
  CONCLUSIONS
  In this study, rTMS was found to be a safe, well-tolerated treatment, and a useful adjunctive treatment to medications in elderly treatment-resistant depressed patients. This study contributes to the existing evidence on the antidepressant effect of rTMS in the treatment of depression in patients over 60 years of age.
authors.affiliation: Uskudar University, Neuropsychiatry Istanbul Hospital, Department of Psychiatry, Istanbul, Turkey.
authors.forename: Gokben
authors.initials: G
authors.lastname: Hizli Sayar
authors.forename: Eylem
authors.initials: E
authors.lastname: Ozten
authors.forename: Oguz
authors.initials: O
authors.lastname: Tan
authors.forename: Nevzat
authors.initials: N
authors.lastname: Tarhan
keywords: Hamilton Depression Rating Scale; high-frequency repetitive TMS; rTMS