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Dr. Bob is Robert Hsiung, MD,
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Posted by River1924 on February 8, 2006, at 0:30:04
I'm not sure if rTMS is available but this might help someone.
Magnetic Stimulation Hastens Response to Antidepressants
NEW YORK (Reuters Health) Jan 27 - Repetitive transcranial magnetic stimulation (rTMS) can speed the response to antidepressant agents in patients with major depressive disorder, Italian researchers report.
Previous studies looking at rTMS have largely focused on its use for drug-resistant and severe depression and few studies have looked the procedure as an adjunct to drug therapy in patients without resistant disease.
According to senior author Dr. Raffaella Zanardi and colleagues, the present study marks the first time that rTMS has been evaluated as a way to hasten the antidepressant response in a double-blind, randomized, sham-controlled trial.
The 5-week study involved 99 inpatients who were randomized to receive sertraline, venlafaxine, or escitalopram combined with 2 weeks of either real or sham rTMS, note the authors, from Vita-Salute University in Milan. With the real intervention, 15-Hz rTMS was applied to the left dorsolateral prefrontal cortex.
The investigators' findings appear in the Journal of Clinical Psychiatry for December.
Patients treated with the real rTMS experienced a faster drop in the Hamilton Rating Scale for Depression (HAM-D) than did patients given the sham treatment (p = 0.0029). The rTMS-treated patients showed a significantly greater drop in the HAM-D score at each week of the study, except the last.
Also, rTMS appeared to be equally effective in hastening the response to the three antidepressant agents tested.
"Many of our patients achieved a fast response and were remitters at the end of the trial," the authors comment. "However, it is reasonable to hypothesize that a longer period of rTMS treatment for those who did not respond may have yielded an even higher response rate."
J Clin Psychiatry 2005;66:1569-1575.
Posted by River1924 on February 8, 2006, at 0:35:08
In reply to rTMS, posted by River1924 on February 8, 2006, at 0:30:04
Magnetic Stimulation May Be Effective Maintenance Therapy for Major Depression
Reuters Health Information 2006. © 2006 Reuters Ltd.
Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.NEW YORK (Reuters Health) Jan 30 - Repetitive transcranial magnetic stimulation (rTMS) may be an effective and safe long-term maintenance therapy for some patients with major depressive disorder, results of an open-label study published in the December issue of the Journal of Clinical Psychiatry indicate.
"There is growing evidence to support the short-term antidepressant effects of rTMS, but few published data pertain to the maintenance treatment of patients with DSM-IV diagnosed major depressive disorder who have responded acutely to rTMS," write Dr. John P. O'Reardon and colleagues from the University of Pennsylvania, Philadelphia.
The researchers examined the long-term efficacy of rTMS in 10 patients (mean age 50 years) with major depressive disorder over periods ranging from 6 months to 6 years.
rTMS was applied over the left prefrontal cortex at 100% of motor threshold, usually at 10 Hz for 40 trains at 5 seconds per train with a 25-second intertrain interval of no stimulation. Session frequency averaged 1 to 2 per week, and a total of 1831 rTMS sessions were documented.
The physician-rated Clinical Global Impressions-Improvement scale (CGI-I) measure was used to assess the clinical benefits of rTMS maintenance. These ratings were cross-checked with the patients' self-rated global impression of improvement.
Of the 10 subjects, five experienced marked benefit from rTMS therapy. These patients underwent a mean of 257 rTMS sessions at a session frequency of 2.1 per week. Three of the patients did not require any concurrent antidepressant medication.
An additional two patients experienced moderate benefit. These subjects received a mean of 125 rTMS sessions at a session frequency of 1.8 per week. Both experienced a recurrence of major depressive disorder.
"Three patients experienced only minimal benefit from rTMS and received a mean of 98 sessions (1.7 per week) each," Dr. O'Reardon's team notes. "Two of the three patients experienced recurrences of depression, and none maintained a sustained improvement during maintenance therapy despite the addition of antidepressant medication," they write. "In these patients, rTMS was ultimately discontinued due to inadequate results."
The investigators point out that the patients who responded most strongly to acute treatment tended to benefit most from maintenance rTMS, but more research is needed to identify patients who are likely be helped by the modality in the long term.
J Clin Psychiatry 2005;66:1524-1528.
Posted by deniseuk on February 8, 2006, at 11:09:55
In reply to rTMS article#2, posted by River1924 on February 8, 2006, at 0:35:08
I tried rTMS and it didn't work for me. However, I did read somewhere that they were trying to develop a better rTMS machine which penetrated deeper into the brain.
rTMS didn't seem to do a thing for me.
Denise
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