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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Iansf on February 8, 2006, at 19:47:29
Magnetic Stimulation Hastens Response to Antidepressants
Reuters Health Information 2006. © 2006 Reuters Ltd.
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."
Posted by linkadge on February 9, 2006, at 9:04:46
In reply to Magnetic Stimulation Antidepressants, posted by Iansf on February 8, 2006, at 19:47:29
I think that rTMS is a good procedue, and probably safer than ECT. But how much do we really know about its safety.
Linkadge
Posted by Schess81 on February 9, 2006, at 18:31:36
In reply to Magnetic Stimulation Antidepressants, posted by Iansf on February 8, 2006, at 19:47:29
heres a link-
http://psychiatrymmc.com/displayArticle.cfm?articleID=article112
Posted by ghostshadow on February 10, 2006, at 12:22:45
In reply to here's another informative rTMS article, posted by Schess81 on February 9, 2006, at 18:31:36
sounds safer than ECT and better than drugs. be nice if it could replace the need for meds...
Posted by Pfinstegg on February 13, 2006, at 18:49:15
In reply to Magnetic Stimulation Antidepressants, posted by Iansf on February 8, 2006, at 19:47:29
When I went to have TMS with Dr. Hutto in Atlanta last week, I noticed that the treatment was given in a new, well-decorated room, with a big sign on the door which said "Center for TMS". Before, there was no sign, and no special office. It was the same (old) Neuronetics machine, but Dr. Hutto told me that he has his order in for the new one, and expects that it will become an approved treatment sometime this year. He said he wanted to give me 120%, rather than 110% of the motor threshold stimulation; I agreed, and it hurt even more, but I think it helped more, as well. He said he and his colleagues are turning their attention to the best maintenance protocols, and are thinking that some people (with the most tendency towards relapse) will remain in the best remission if they receive one treatment on a weekly basis- that's if they have responded favorably to an initial course of 15-20 treatments. He said that they are having about equal success with both bipolar and unipolar depression- about 50%. He did say, though, that some other centers report about a 75% success rate when both TMS and ADs are used vigorously, and that his own treatment population tends to be a "tough" one- with lots of patients who have failed with ADs and have needed ECT. Although I don't exactly feel that way about myself much of the time, he considers me one of his "easy, uncomplicated" patients. Well, I guess I'll take it as a compliment of a sort!
Posted by linkadge on February 13, 2006, at 20:13:24
In reply to An update from the field.., posted by Pfinstegg on February 13, 2006, at 18:49:15
I'm liking your rTMS Tianeptine combination. That sound like an award winning combination, in terms of the HPA axis.
Linkadge
Posted by Pfinstegg on February 14, 2006, at 0:43:20
In reply to Re: An update from the field.., posted by linkadge on February 13, 2006, at 20:13:24
Yes, Link, it's the best I've found so far. I was really encouraged when Dr. Hutto told me that TWO of his other patients had also gotten themselves onto the same combination- and that they were pleased with it too.
This is the end of the thread.
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