Effectiveness of adjunctive repetitive transcranial magnetic stimulation in management of treatment-resistant depression: A retrospective analysis

Indian J Psychiatry. 2018 Jul-Sep;60(3):329-333. doi: 10.4103/psychiatry.IndianJPsychiatry_182_16.


Background: There is limited number of studies from India investigating role of repetitive transcranial magnetic stimulation (rTMS) in treatment-resistant depression (TRD). This clinic-based study reports on the efficacy of rTMS as an add-on treatment in patients suffering from TRD.

Materials and methods: Twenty-two right-handed patients suffering from major depressive disorder who failed to respond to adequate trials of at least two antidepressants drugs in the current episode received rTMS as an augmenting treatment. High-frequency (Hf) rTMS at 110% of the estimated resting motor threshold (MT) was given over the left dorsolateral prefrontal cortex (DLPFC). A total of 15 sessions were given over 3 weeks with 3000 pulses per session. The outcome was assessed based on the changes in scores of Hamilton Rating Scale for Depression or Montgomery-Asberg Depression Rating Scale.

Results: There was a significant reduction in final assessment scores after rTMS intervention as compared to baseline with almost 50% of the participants showing response in either scale.

Conclusion: Hf rTMS applied over left DLPFC is an effective add-on treatment strategy in patients with TRD.

Keywords: Brain stimulation; depression; transcranial magnetic stimulation.