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Modest adjunctive benefit with transcranial magnetic stimulation in medication-resistant depression
M Garcia-Toro1, A Mayol, H Arnillas
1Complejo Hospitalario GESMA, C/Jesús 40, 07003 Palma de Mallorca, Mallorca, Spain. magato@intersalud.es
Background:
Controverted results have been obtained using high frequency transcranial magnetic stimulation (HF-rTMS) as an antidepressant treatment.
Methods:
Forty patients suffering from drug-resistant major depression received ten sessions of HF-rTMS at 90% of the motor threshold on the left prefrontal cortex or sham stimulation, added to their pharmacological treatment, in a randomized double-blind design. In a second open phase, patients still fulfilling criteria of inclusion received ten additional sessions of HF-rTMS at 90 or 110%.
Results:
Real, but not sham HF-rTMS, was associated with a significant decrease in the Hamilton Depression Rating Scale, but only twelve patients decreased more than 50%.
Conclusions:
Left prefrontal HF-rTMS was effectively associated with antidepressant treatment, although the size effect was small.
Limitations:
Shortage of the sample and control difficulties of the placebo effect.
Clinical Relevance:
Questionable in more than half of the patients studied.