Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-24T05:49:28.574Z Has data issue: false hasContentIssue false
  • English
  • Français

The Clinical Future of Repetitive Transcranial Magnetic Stimulation and Depression: Separating Hope From Hype

Published online by Cambridge University Press:  07 November 2014

Stefano Pallanti ,
Thomas E. Schlaepfer  and
Sarah H. Lisanby
Get access Rights & Permissions [Opens in a new window]

Extract

One of the key messages of the Sequenced Treatment Alternatives to Relieve Depression study was that only one third of patients with a diagnosis of major depressive disorder (MDD) achieve remission after the first treatment with an antidepressant. Management of most patients after one or more failed trials moves beyond the currently available evidence base and therefore represents a significant clinical challenge. Over the course of the four treatment steps, the cumulative remission rate was 67% and remission was more likely to occur during the first two treatment levels (20% to 30%) rather than during levels 3 and 4 (10% to 20%). These finding suggest that after two consecutive unsuccessful antidepressant trials a change in pharmacologic mode of action has a low probability to affect the likelihood of remission from MDD. The switch to a third antidepressant treatment resulted in an even lower remission rate than the one achieved in the first two levels. Furthermore, the discontinuation rates due to treatment intolerance was shown to rise across sequenced levels. At this point, the search for effective and tolerable alternative options to pharmacotherapy is essential.

Type
Brain Stimulation
Information
CNS Spectrums , Volume 15 , Issue 9 , September 2010 , pp. 554 - 557
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Rush, AJ, Fava, M, Wisniewski, SR, et al. Sequenced treatment alternatives to relieve depression (STAR*D): rationale and design. Control Clin Trials. 2004; 25(1): 119–142.Google Scholar
2.Kosel, M, Schlaepfer, TE. Beyond the treatment of epilepsy: New applications of vagus nerve stimulation (VNS) in psychiatry. CNS Spectr. 2003; 8(7): 515–521.Google Scholar
3.Schlaepfer, T, Frick, C, Zobel, A, et al. Vagus nerve stimulation for depression: efficacy and safety in a European study. Psychol Med. 2008; 38: 651–662.Google Scholar
4.Barker, AT, Jalinous, R, Freeston, IL. Non-invasive magnetic stimulation of human motor cortex. Lancet. 1985; 1 (8437): 1106–1107.Google Scholar
5.Chen, R, Classen, J, Gerloff, C, et al. Depression of motor cortex excitability by low-frequency transcranial magnetic stimulation. Neurology. 1997; 48(5): 1398–1403.Google Scholar
6.Pascual-Leone, A, Tormos, JM, Keenan, J, Tarazona, F, Canete, C, Catala, MD. Study and modulation of human cortical excitability with transcranial magnetic stimulation. J Clin Neurophysiol. 1998; 15(4): 333–343.Google Scholar
7.Slotema, CW, Blom, JD, Hoek, HW, Sommer, IE. Should we expand the toolbox of psychiatric treatment methods to include repetitive transcranial magnetic stimulation (rTMS)? a meta-analysis of the efficacy of rTMS in psychiatric disorders. J Clin Psychiatry. 2010; 71(7): 873–874.Google Scholar
8.Janicak, PG, O'Reardon, JP, Sampson, SM, et al. Transcranial magnetic stimulation in the treatment of major depressive disorder: a comprehensive summary of safety experience from acute exposure, extended exposure, and during reintroduction treatment. J Clin Psychiatry. 2008; 69(2): 222–232.Google Scholar
9.Chen, R, Gerloff, C, Classen, J, Wassermann, EM, Hallett, M, Cohen, LG. Safety of different inter-trains intervals for repetitive transcranial magnetic stimulation and recommendations for safe ranges of stimulation paremeters. Electroencephalogr Clin Neurophysiol. 1997; 105: 415–421.Google Scholar
10.Tharayil, BS, Gangadhar, BN, Thirthalli, J, Anand, L. Seizure with single-pulse transcranial magnetic stimulation in a 35-year-old otherwise-healthy patient with bipolar disorder. J Ect. 2005; 21(3): 188–189.Google Scholar
11.Brunoni, AR, Fraguas, R, Fregni, F. Pharmacological and combined interventions for the acute depressive episode: focus on efficacy and tolerability. Ther Clin Risk Manag. 2009; 5: 897–910.Google Scholar
12.Rossini, D, Magri, L, Lucca, A, Giordani, S, Smeraldi, E, Zanardi, R. Does rTMS hasten the response to escitalopram, sertraline, or venlafaxine in patients with major depressive disorder? A double-blind, randomized, sham-controlled trial. J Clin Psychiatry. 2005; 66(12): 1569–1575.Google Scholar
13.Lisanby, SH, Husain, MM, Rosenquist, PB, et al. Daily left prefrontal repetitive transcranial magnetic stimulation in the acute treatment of major depression: clinical predictors of outcome in a multisite, randomized controlled clinical trial. Neuropsychopharmacol. 2009; 34: 522–534.Google Scholar
14.Simpson, KN, Welch, MJ, Kozel, FA, Demitrack, MA, Nahas, Z. Cost-effectiveness of transcranial magnetic stimulation in the treatment of major depression: a health economics analysis. Adv Ther. 2009; 26(3): 346–368.Google Scholar
15.Grossheinrich, N, Rau, A, Pogarell, O, et al. Theta burst stimulation of the prefrontal cortex: safety and impact on cognition, mood, and resting electroencephalogram. Biol Psychiatry. 2009; 65(9): 778–784.Google Scholar
16.Chistyakov, AV, Rubicsek, O, Kaplan, B, Zaaroor, M, Klein, E. Safety, tolerability and preliminary evidence for antidepressant efficacy of theta-burst transcranial magnetic stimulation in patients with major depression. Int J Neuropsychopharmacol. 2010; 13(3): 387–393.Google Scholar
17.Levkovitz, . Deep transcranial magnetic stimulation over the prefrontal cortex: evaluation of antidepressant and cognitive effects in depressive patients. Brain Stim. 2009; 2: 188–200.Google Scholar
18.Stern, WM, Tormos, JM, Press, DZ, Pearlman, C, Pascual-Leone A. Antidepressant effects of high and low frequency repetitive transcranial magnetic stimulation to the dorsolateral prefrontal cortex: a double-blind, randomized, placebo-controlled trial. J Neuropsychiatry Clin Neurosci. 2007; 19(2): 179–186.Google Scholar
19.Fitzgerald, PB, Hoy, K, Daskalakis, ZJ, Kulkarni, J. A randomized trial of the antidepressant effects of low- and high-frequency transcranial magnetic stimulation in treatment-resistant depression. Depress Anxiety. 2009; 26(3): 229–234.Google Scholar
20.O'Reardon, JP, Solvason, HB, Janicak, PG, et al. Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial. Biol Psychiatry. 2007; 62(11): 1208–1216.Google Scholar
21.Fitzgerald, PB, Benitez, J, de Castella, A, Daskalakis, ZJ, Brown, TL, Kulkarni, J. A randomized, controlled trial of sequential bilateral repetitive transcranial magnetic stimulation for treatment-resistant depression. Am J Psychiatry. 2006; 163(1): 88–94.Google Scholar
22.Pallanti, S, Bernardi, S, Di Rollo, A, Antonini, S, Quercioli, L. Unilateral low frequency versus sequential bilateral repetitive transcranial magnetic stimulation: is simpler better for treatment of resistant depression? Neurosci. 2010; 167(2): 323–328.Google Scholar
23.Holtzheimer, PE, 3rd, Russo, J, Claypoole, KH, Roy-Byrne, P, Avery, DH. Shorter duration of depressive episode may predict response to repetitive transcranial magnetic stimulation. Depress Anxiety. 2004; 19(1): 24–30.Google Scholar