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Related Concept Videos

Antidepressant Drugs: MAOIs and Other Agents01:23

Antidepressant Drugs: MAOIs and Other Agents

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Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
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Meta-regression insights for optimizing accelerated neuromodulation protocols in major depression.

Mauro Pettorruso1, Marta Borgi2, Lorenzo Pio Padula3

  • 1Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Department of Mental Health, ASL 2 Abruzzo Lanciano-Vasto-Chieti, Chieti, Italy; Institute for Advanced Biomedical Technologies (ITAB), "G. d'Annunzio" University of Chieti-Pescara, Italy.

Journal of Psychiatric Research
|November 2, 2025
PubMed
Summary

Accelerated repetitive transcranial magnetic stimulation (rTMS) shows promise for depression. Higher pulse counts and over 20 sessions significantly improve antidepressant effects, with longer breaks between sessions also aiding effectiveness.

Keywords:
Bipolar depressionDepressionFast-actingRepetitive transcranial magnetic stimulationTreatmentTreatment-resistant depression

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Area of Science:

  • Neuromodulation
  • Psychiatry
  • Neuroscience

Background:

  • Accelerated repetitive transcranial magnetic stimulation (arTMS) is a time-efficient treatment for major depressive episodes.
  • Significant variability exists in arTMS parameters and patient outcomes.
  • Optimizing arTMS protocols is crucial for enhancing clinical efficacy.

Purpose of the Study:

  • To provide preliminary insights for optimizing accelerated excitatory rTMS protocols.
  • To identify key stimulation parameters influencing clinical efficacy in depression treatment.
  • To analyze dose-response relationships in arTMS for major depressive disorder, treatment-resistant depression, and bipolar depression.

Main Methods:

  • Conducted a meta-regression analysis of controlled and uncontrolled trials.
  • Included studies on high-frequency prefrontal cortex arTMS and intermittent Theta Burst Stimulation (aiTBS).
  • Analyzed data from 25 interventions (810 participants, 722 sessions) for depression response rates.

Main Results:

  • A significant dose-response relationship was observed between stimulation parameters and clinical outcomes.
  • Higher pulse counts and more than 20 total sessions correlated with enhanced antidepressant effects.
  • Longer intersession intervals (≥50 minutes) positively influenced treatment effectiveness; no modality differences found.

Conclusions:

  • Parameter settings in accelerated rTMS protocols significantly impact clinical outcomes.
  • Findings offer guidance for optimizing neuromodulation strategies for depression treatment.
  • Further research can refine arTMS protocols for improved patient response rates.