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

  • COLLEEN K. LOO (a1), PHILIP B. MITCHELL (a1), TARA F. McFARQUHAR (a1), GIN S. MALHI (a1) and PERMINDER S. SACHDEV (a1)...

Abstract

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.

Copyright

Corresponding author

The Black Dog Institute, Prince of Wales Hospital, Hospital Road, Randwick NSW 2031, Australia. (Email: colleen.loo@unsw.edu.au)

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