Summary and Comment | TMS in Psychiatry Fall, 2013
Patients with MDD treated with rTMS still improved after 6 months Geoffrey Grammer MD reviewing Janicak PG, Nahas Z, Lisanby SH, Solvason HB Brain Stimul. 2010 Oct
Conclusion In patients pharmacotherapy-resistant MDD who received rTMS, after 6 months, 10% of patients relapsed, and if they did experience clinical worsening, the vast majority responded to additional TMS treatments.
Device, Parameters NeuroStar; Background of article Three hundred one patients were randomly assigned to active or sham rTMS in a 6-week, controlled trial. Nonresponders could enroll in a second, 6-week, open-label study. Patients who met criteria for partial response (decreased their baseline HAMD 17 scores by at least 25%) during either the sham-controlled or open-label study (n = 142) were tapered off rTMS over 3 weeks, while simultaneously starting maintenance antidepressant monotherapy most commonly with either duloxetine, venlafaxine, buproprion, or escitalopram. Patients were then followed for 24 weeks in order to study the long-term durability of rTMS. Repetitive TMS was re-administered if patients' symptoms worsened, as determined by any drop on the CGI-S scale for 2 consecutive weeks. Retreatment consisted of 2 sessions/week for 2 weeks, then 5 sessions/week for 4 weeks or until symptoms returned to baseline. Relapse was the primary outcome measure. Ten of 99 subjects relapsed during the 24 week observation, defined as meeting DSM-IV criteria for depression. Thirty-eight of the 99 subjects experienced some symptom worsening and received additional TMS treatment, which yielded symptomatic benefit in 32 of the 38 (84%). Comment This is a remarkably complex study that helps answer the vital question of durability. With 60% of patients maintaining their gains from TMS on antidepressant monotherapy, providers can reassure patients that benefits for many are not short lived. Also reassuring is that of those who did have clinical worsening, the vast majority responded to additional TMS treatments. Citation(s): Brain Stimul. 2010 Oct;3(4):187-99. doi: 10.1016/j.brs.2010.07.003. Epub 2010 Aug 11. Durability of clinical benefit with transcranial magnetic stimulation (TMS) in the treatment of pharmacoresistant major depression: assessment of relapse during a 6-month, multisite, open-label study.
Janicak PG, Nahas Z, Lisanby SH, Solvason HB, Sampson SM, McDonald WM, Marangel LB, Rosenquist P, McCal WV, Kimball J, O'Reardon JP, Loo C, Husain MH, Krystal A, Gilmer W, Dowd SM, Demitrack MA, Schatzberg AF.
Department of Psychiatry, Rush University Medical Center, Chicago, Il inois 60612, USA. [email protected]PubMed Abstract (http://www.ncbi.nlm.nih.gov/pubmed/20965447) YOUR COMMENT: Name * Email * (will not be published) Professional Category
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See more at: PubMed Abstract (http://www.ncbi.nlm.nih.gov/pubmed/20965447)
2007 ― NAKANO Takayoshi Scientific Papers/Commentary Articles 1. T. Nakano, T. Ishimoto, J.-W. Lee and Y. Umakoshi, Preferential orientation of biological apatite crystallite in original, regenerated and diseased cortical bones, Journal of the Ceramic Society of 2. K. Koizumi, Y. Minamino, T Nakano and Y. Umakoshi, Effects of antiphase domains on dislocation motion in Ti3Al single c
HERMINE HAIDVOGEL, SALZBURG DIE BLUTSÄULE. ZEICHEN UND WUNDER AM SERETH SOMA MORGENSTERNS TOTENBUCH FÜR DIE OPFER DER SHOAH Wenn die jüdischen Städtel noch existierten, würden sie für mich nur einer fernen Vergangenheit angehören; da sie vernichtet, so ausgerottet worden sind, dass nichts von dem, was sie gewesen sind und hätten werden können, in die Zukunft hinüberrei