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, Philip G.; Nahas, Ziad; Lisanby, Sarah H.; Solvason, H. Brent; Sampson, Shirlene; McDonald, William M.; Marangell, Lauren B.; Rosenquist, Peter B.; McCall, W. Vaughn; Kimball, James; O’Reardon, John P.; Loo, Colleen; Husain, Mustafa H.; Krystal, Andrew D.; Gilmer, William S.; Dowd, Sheila M.; Demitrack, Mark A.; Schatzberg, Alan F.

doi:10.1016/j.brs.2010.07.003

Cited by 130 publications

(88 citation statements)

References 18 publications

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“…12,18 The report by Mantovani and colleagues 18 followed a cohort of patients (N = 50) for 3 months who had remitted (HDRS-24 score ≤ 10) following acute TMS in either an earlier multisite randomized trial 14 or an open-label follow-up study, 35 in which patients were tapered off TMS and transitioned to maintenance medications. At 3 months, 29 of 50 patients (58.0%) remained in remission (HDRS-24 score < 11), with an overall relapse rate of 13.5% (HDRS-24 score ≥ 20).…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7][8][9][10][11] Transcranial magnetic stimulation (TMS) is a safe, effective, and well-tolerated alternative to pharmacotherapy for MDD. [12][13][14][15][16][17][18] Cumulative data in the last decade support that benefit of acute TMS appears sustained over periods of weeks to months. 12,[18][19][20][21][22][23][24] Upon symptom reemergence, reintroduction of TMS often results in restoration of acute benefit.…”

mentioning

confidence: 99%

“…12,[18][19][20][21][22][23][24] Upon symptom reemergence, reintroduction of TMS often results in restoration of acute benefit. 12,21,22,25 Nevertheless, definitive conclusions regarding durability of benefit from these studies are limited by the use of different treatment parameters and durations of acute treatment.…”

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confidence: 99%

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A Multisite, Naturalistic, Observational Study of Transcranial Magnetic Stimulation for Patients With Pharmacoresistant Major Depressive Disorder

Dünner¹,

Aaronson²,

Sackeïm³

et al. 2014

J. Clin. Psychiatry

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121

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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A Multisite, Naturalistic, Observational Study of Transcranial Magnetic Stimulation for Patients With Pharmacoresistant Major Depressive Disorder

Dünner¹,

Aaronson²,

Sackeïm³

et al. 2014

J. Clin. Psychiatry

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121

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“…Also, Aguirre et al (2011) have shown that the rates of response and remission 4 weeks post-treatment increased from 33.3-38.9% (ie, from 6-7 subjects) and from 5.5-16.7% (ie, from 1-3 subjects) for the LF-rTMS group, respectively, and were maintained at the same initial level for the sham rTMS group. Encouragingly, a recent 6-month follow-up study with over 90 depressed subjects has shown that the therapeutic benefits of highfrequency rTMS are durable, and that it can be used for precluding impending relapse (Janicak et al, 2010). Nevertheless, it is clear that future RCTs on rTMS should include longer follow-up periods (eg, 46-12 months), especially considering the labor-intensive and time-consuming nature of rTMS (Wassermann and Zimmermann, 2012).…”

Section: Limitationsmentioning

confidence: 99%

Clinically Meaningful Efficacy and Acceptability of Low-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) for Treating Primary Major Depression: A Meta-Analysis of Randomized, Double-Blind and Sham-Controlled Trials

Berlim

Eynde

Daskalakis

2012

Neuropsychopharmacol

244

140

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Clinical trials on low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) over the right dorsolateral prefrontal cortex have yielded conflicting evidence concerning its overall efficacy for treating major depression (MD). As this may have been the result of limited statistical power of individual trials, we have carried the present systematic review and meta-analysis to examine this issue. We searched the literature for English language randomized, double-blind and sham-controlled trials (RCTs) on LF-rTMS for treating MD from 1995 through July 2012 using EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, SCOPUS, and ProQuest Dissertations & Theses, and from October 2008 until July 2012 using MEDLINE. The main outcome measures were response and remission rates as well as overall dropout rates at study end. We used a random-effects model, odds ratios (ORs) and number needed to treat (NNT). Data were obtained from eight RCTs, totaling 263 subjects with MD. After an average of 12.6±3.9 rTMS sessions, 38.2% (50/131) and 15.1% (20/132) of subjects receiving active LF-rTMS and sham rTMS were classified as responders (OR ¼ 3.35; 95% CI ¼ 1.4-8.02; p ¼ 0.007). Also, 34.6% (35/101) and 9.7% (10/103) of subjects receiving active LF-rTMS and sham rTMS were classified as remitters (OR ¼ 4.76; 95% CI ¼ 2.13-10.64; po0.0001). The associated NNT for both response and remission rates was 5. Sensitivity analyses have shown that protocols delivering 41200 magnetic pulses in total as well as those offering rTMS as a monotherapy for MD were associated with higher rates of response to treatment. No differences on mean baseline depression scores and dropout rates for active and sham rTMS groups were found. Finally, the risk of publication bias was low. In conclusion, LF-rTMS is a promising treatment for MD, as it provides clinically meaningful benefits that are comparable to those of standard antidepressants and high-frequency rTMS. Furthermore, LF-rTMS seems to be an acceptable intervention for depressed subjects.

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“…A recent RCT [20] that described the time course of continued benefit after 6 weeks of highfrequency TMS to left DLPFC by using as maintenance antidepressant monotherapy, found a relapse rate of 10.1%. These results are comparable to ours, with the difference that in our study the follow-up was mostly naturalistic in nature and shorter.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Efficacy of Repeated Daily Prefrontal Transcranial Magnetic Stimulation (TMS) In Treatmnt-Resistant Depression

Mantovani

Pavlicová

Avery

et al. 2016

FOC

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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

Cited by 130 publications

References 18 publications

A Multisite, Naturalistic, Observational Study of Transcranial Magnetic Stimulation for Patients With Pharmacoresistant Major Depressive Disorder

A Multisite, Naturalistic, Observational Study of Transcranial Magnetic Stimulation for Patients With Pharmacoresistant Major Depressive Disorder

Clinically Meaningful Efficacy and Acceptability of Low-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) for Treating Primary Major Depression: A Meta-Analysis of Randomized, Double-Blind and Sham-Controlled Trials

Long-Term Efficacy of Repeated Daily Prefrontal Transcranial Magnetic Stimulation (TMS) In Treatmnt-Resistant Depression

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