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延长课程加速间歇性甲基突发刺激作为需要电治疗的抑郁患者的替代品

Michelle S Goodman¹, Alisson P Trevizol^1,2, Gerasimos N Konstantinou^1,2

¹Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada.

Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology

|October 24, 2024

概括

在限制电疗法 (ECT) 时,延长时间的加速间歇性甲突发刺激 (aiTBS) 安全治疗严重抑郁症. 这种aiTBS协议显示出显著的临床改善,并减少了对ECT服务的压力.

科学领域:

神经科学是一个神经科学.
精神病学是一个精神病学.
临床试验临床试验

背景情况:

在COVID-19大流行期间,对电疗法 (ECT) 访问的限制使严重抑郁症的替代治疗成为必要.
加快间歇性甲基突破刺激 (aiTBS) 已成为需要紧急干预的患者的潜在替代方案.
确定了在严重抑郁症中评估延长aiTBS协议的需要.

研究的目的:

评估中度至重度抑郁症患者aiTBS延长疗程的临床结果和服务影响.
评估aiTBS作为ECT的替代品,特别是在限制访问期间.
确定治疗抑郁症和预防复发的多阶段aiTBS协议的安全性和有效性.

主要方法:

一项开放的临床试验,涉及155名中度至重度抑郁症患者.
一个三个阶段的治疗方案:急性 (每天8次iTBS会话长达10天),逐渐减少 (减少2周),并预防复发 (基于症状长达6个月).
使用汉密尔顿抑郁症评分表 (HRSD-24) 来衡量治疗有效性.

主要成果:

急性阶段:16.1%的缓解率,25.2%的应答率和29.4%的平均HRSD-24得分降低.
减速阶段:34.8%的缓解率,49.6%的响应率和42.6%的平均HRSD-24减少.
复发预防阶段:60.1%的平均HRSD-24减少,在43名完成者中只有7次复发.

结论:

一个扩展的aiTBS协议在患有严重抑郁症的患者中安全地实现了有意义的临床结果.
aiTBS是ECT的有效替代品,在疫情期间减轻了ECT服务的压力.
这项研究支持使用延长的aiTBS治疗严重抑郁症和预防复发.

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