Usefulness of repetitive transcranial magnetic stimulation as a maintenance treatment in patients with major depression.
To investigate the clinical efficacy of repetitive transcranial magnetic stimulation (rTMS), venlafaxine or a combination of both treatments as a maintenance treatment in patients with treatment-resistant depression (TRD).



In a three-arm open-label study, 66 patients, including 45 remitters, who responded to rTMS (n = 25), venlafaxine (n = 22), or a combination of both treatments (n = 19) continued to receive the treatment that led to a response as a maintenance treatment over 12 months. Maintenance rTMS was administered twice per week for 1 month, once per week for 2 months, and once every 2 weeks for 9 months. Venlafaxine was maintained at the dose that induced a clinical response (150 or 225 mg/day).



After the 12-month follow-up, the rates of remitters (HDRS < 8) were not different between the three groups (χ2=1.25; P = .3). The rates of patients who not relapsed (HDRS < 15) were not different between groups (χ2=0.33; P = .8): 40.0% in the rTMS group, 45.1% in the venlafaxine group and 36.9% in the combination group.



The three maintenance approaches exhibited similar efficacies in relapse prevention and the maintenance of remission in patients with TRD.
a INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, ΨR2 Team , University Lyon , France.|b Centre Hospitalier Le Vinatier , Bron , France.
Frédéric
F
Haesebaert
a INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, ΨR2 Team , University Lyon , France.|b Centre Hospitalier Le Vinatier , Bron , France.
Rémi
R
Moirand
c Pôle "Information Médicale Evaluation Recherche" (IMER) , Lyon , France.
Anne-Marie
AM
Schott-Pethelaz
a INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, ΨR2 Team , University Lyon , France.|b Centre Hospitalier Le Vinatier , Bron , France.
Jérôme
J
Brunelin
a INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, ΨR2 Team , University Lyon , France.|b Centre Hospitalier Le Vinatier , Bron , France.|d Service de Psychiatrie des urgences , CHU Lyon, Hôpital Edouard Herriot , Lyon , France.
Emmanuel
E
Poulet
D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage / Q000494:pharmacology*; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000517:prevention & control / Q000628:therapy*; D061218:Depressive Disorder, Treatment-Resistant / Q000188:drug therapy / Q000517:prevention & control / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012074:Remission Induction; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D000069470:Venlafaxine Hydrochloride / Q000008:administration & dosage / Q000494:pharmacology*
D018687:Antidepressive Agents, Second-Generation; D000069470:Venlafaxine Hydrochloride
DLPFC; Depression; maintenance treatment; rTMS; transcranial magnetic stimulation