A randomized, sham-controlled study of maintenance rTMS for treatment-resistant depression (TRD)

An Update on Repetitive Transcranial Magnetic Stimulation for the Treatment of Major Depressive Disorder

“…The authors reported no difference between the active and sham groups at months 2 and 3-with the benefits sustained for 2 months, suggesting that weekly sessions showed beneficial effects during the fourth month of treatment, which was not observed when switched to one session every 2 weeks. 46 A 12-month follow-up study comparing maintenance rTMS delivered monthly vs. observation only reported no significant group differences on any outcome measure, although the maintenance group was associated with a nonsignificantly longer time to relapse (91 ± 66 days vs. 77 ± 52 days). 47 A clinical trial on rTMS, venlafaxine, or a combination of both as a maintenance treatment in patients with TRD in a three-arm open-label study (N = 66; twice-weekly rTMS maintenance for 1 month and once every 2 weeks for 9 months; and the venlafaxine maintained at the dose that induced a clinical response using 150 or 225 mg/day) showed no difference in the proportion of subjects who did not relapse in a 12-month follow-up.…”

“…Responders were randomized into two arms, with active or sham HFL ( N = 10 and 7, respectively), with three sessions per week for the first 2 weeks, followed by two sessions per week for 2 weeks, one session per week for 2 months, and one session every 2 weeks for 8 months. The authors reported no difference between the active and sham groups at months 2 and 3—with the benefits sustained for 2 months, suggesting that weekly sessions showed beneficial effects during the fourth month of treatment, which was not observed when switched to one session every 2 weeks …”

Is Maintenance Repetitive Transcranial Magnetic Stimulation for Patients With Depression a Valid Therapeutic Strategy?

“…In a second study, 17 patients who had responded to an initial course of rTMS were randomized to receive either active (10) or sham (7) maintenance treatment for 11 months . The schedule reduced from 3 sessions per week to 1 session every 2 weeks.…”

“…In a second study, 17 patients who had responded to an initial course of rTMS were randomized to receive either active (10) or sham (7) maintenance treatment for 11 months. 7 The schedule reduced from 3 sessions per week to 1 session every 2 weeks. There was a greater improvement in depression in the active group in the first 3 months of follow-up, although not after this time when the frequency of TMS sessions was reduced from weekly to every second week.…”

“…It is possible that the failure of the differences in this study to reach significance arose from the limited sample size, although the overall "low dose" of treatment (sessions only once monthly) may well have contributed.In a second study, 17 patients who had responded to an initial course of rTMS were randomized to receive either active (10) or sham (7) maintenance treatment for 11 months. 7 The schedule reduced from 3 sessions per week to 1 session every 2 weeks. There was a greater improvement in depression in the active group in the first 3 months of follow-up, although not after this time when the frequency of TMS sessions was reduced from weekly to every second week.…”