Document Detail

Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial.
MedLine Citation:
PMID:  17573044     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We tested whether transcranial magnetic stimulation (TMS) over the left dorsolateral prefrontal cortex (DLPFC) is effective and safe in the acute treatment of major depression. METHODS: In a double-blind, multisite study, 301 medication-free patients with major depression who had not benefited from prior treatment were randomized to active (n = 155) or sham TMS (n = 146) conditions. Sessions were conducted five times per week with TMS at 10 pulses/sec, 120% of motor threshold, 3000 pulses/session, for 4-6 weeks. Primary outcome was the symptom score change as assessed at week 4 with the Montgomery-Asberg Depression Rating Scale (MADRS). Secondary outcomes included changes on the 17- and 24-item Hamilton Depression Rating Scale (HAMD) and response and remission rates with the MADRS and HAMD. RESULTS: Active TMS was significantly superior to sham TMS on the MADRS at week 4 (with a post hoc correction for inequality in symptom severity between groups at baseline), as well as on the HAMD17 and HAMD24 scales at weeks 4 and 6. Response rates were significantly higher with active TMS on all three scales at weeks 4 and 6. Remission rates were approximately twofold higher with active TMS at week 6 and significant on the MADRS and HAMD24 scales (but not the HAMD17 scale). Active TMS was well tolerated with a low dropout rate for adverse events (4.5%) that were generally mild and limited to transient scalp discomfort or pain. CONCLUSIONS: Transcranial magnetic stimulation was effective in treating major depression with minimal side effects reported. It offers clinicians a novel alternative for the treatment of this disorder.
John P O'Reardon; H Brent Solvason; Philip G Janicak; Shirlene Sampson; Keith E Isenberg; Ziad Nahas; William M McDonald; David Avery; Paul B Fitzgerald; Colleen Loo; Mark A Demitrack; Mark S George; Harold A Sackeim
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2007-06-14
Journal Detail:
Title:  Biological psychiatry     Volume:  62     ISSN:  0006-3223     ISO Abbreviation:  Biol. Psychiatry     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-13     Completed Date:  2008-01-28     Revised Date:  2009-12-17    
Medline Journal Info:
Nlm Unique ID:  0213264     Medline TA:  Biol Psychiatry     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1208-16     Citation Subset:  IM    
Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Philadelphia, PA 19014, USA.
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MeSH Terms
Depressive Disorder, Major / psychology,  therapy*
Double-Blind Method
Middle Aged
Psychiatric Status Rating Scales
Transcranial Magnetic Stimulation* / adverse effects,  instrumentation
Treatment Outcome
Comment In:
Biol Psychiatry. 2010 Jan 15;67(2):e13; author reply e15-7   [PMID:  19793580 ]

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