A naturalistic study of transcranial magnetic stimulation (TMS) in major depressive disorder

Background: TMS is effective in the treatment of major depressive disorder (MDD) inplacebo-controlled trials and naturalistic out-patient studies. In Australia, TMS receives norebate (currently), thus, privately insured patients generally receive this treatment asinpatients. Aim: A naturalistic study of the effects of TMS on depressive episodes of MDD inprivate hospital inpatients, to determine whether TMS is effective in severe depression, andwhether age or gender impact on outcome. Method: - and post-treatment HAMD6, visualanalogue scale (VAS6) for depression, and CGI-S. In addition, a mid-treatment VAS6.Patients were grouped according to HAMD6 severity (mild, moderate, severe). Treatment:daily, 10 Hz, 4 second trains, a total of 75 trains at 110% resting motor threshold applied tothe LDLFC. A course of treatment - 20 daily sessions over 26 days. Repeated measuresANCOVA were used to understand the impact of time, gender and age on depression levels.Results: 52 patients with MDD participated – 35% had previously received TMS. Overall,69% achieved remission – including 63.2% (12/19) of those with severe depression. Neitherage nor gender impacted on outcome. Conclusion: A naturalistic inpatient study of TMStreatment of MDD produced remission in 69% of 52 patients – including 63.2% (12/19) withsevere depression. As 35% of patients had received TMS previously, the results were betterthan might otherwise be expected. Neither age nor gender impacted on outcome