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A sham-controlled trial of the efficacy and safety of twice-daily rTMS in major depression

Published online by Cambridge University Press:  19 December 2006

COLLEEN K. LOO ,
PHILIP B. MITCHELL ,
TARA F. McFARQUHAR ,
GIN S. MALHI  and
PERMINDER S. SACHDEV
COLLEEN K. LOO
Affiliation:
School of Psychiatry, University of NSW and Black Dog Institute, Sydney, Australia
PHILIP B. MITCHELL
Affiliation:
School of Psychiatry, University of NSW and Black Dog Institute, Sydney, Australia
TARA F. McFARQUHAR
Affiliation:
School of Psychiatry, University of NSW and Black Dog Institute, Sydney, Australia
GIN S. MALHI
Affiliation:
School of Psychiatry, University of NSW and Black Dog Institute, Sydney, Australia
PERMINDER S. SACHDEV
Affiliation:
School of Psychiatry, University of NSW and Black Dog Institute, Sydney, Australia
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Abstract

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Background. Studies of repetitive transcranial magnetic stimulation (rTMS) in depression have mostly involved once-daily treatment, with positive but modest clinical results. This study tested the efficacy and safety of twice-daily rTMS over 2 weeks.

Method. Thirty-eight depressed subjects enrolled in a double-blind, sham-controlled trial of twice-daily rTMS (left prefrontal cortex, 10 Hz, 110% intensity, 1500 stimuli per session) over 2 weeks. Mood and neuropsychological functioning were assessed weekly by blind raters, using the Montgomery–Asberg Depression Rating Scale (MADRS) as the primary outcome measure, plus the Hamilton Rating Scale for Depression (HRSD) and self-report measures. After the blind period, 22 subjects continued with once-daily rTMS to receive a total of 6 weeks of active rTMS.

Results. Subjects were moderately treatment resistant. Active treatment resulted in significantly greater improvement than sham over the 2-week blind period on one outcome measure only (MADRS p<0·05). Subjects showed further improvement over the 6 weeks of active rTMS. Neuropsychological test scores did not change significantly.

Conclusions. rTMS given twice daily was effective and safe, with no adverse neuropsychological effects.

Type
Original Article
Information
Psychological Medicine , Volume 37 , Issue 3 , March 2007 , pp. 341 - 349
Copyright
2006 Cambridge University Press