TITLE:
Repetitive Transcranial Magnetic Stimulation (rTMS) in Treatment Resistant Depression: Retrospective Data Analysis from Clinical Practice
AUTHORS:
Chris Griffiths, Ksenija da Silva, Robert De Vai, Alex O’Neill-Kerr
KEYWORDS:
Repetitive Transcranial Magnetic Stimulation (rTMS), Treatment Resistant Depression, Service Delivery, Anxiety
JOURNAL NAME:
Open Journal of Depression,
Vol.8 No.1,
January
17,
2019
ABSTRACT: Objective: The aim of this paper
is to present the service data results from a clinical repetitive Transcranial
Magnetic Stimulation (rTMS) service treating treatment resistant depression
(TRD). Methods: The study was a retrospective investigation of routinely
collected data on patients receiving rTMS between 2015 and 2018. Measures used
were the clinician-rated Clinical Global Impression (CGI) and Hamilton
Depression Rating Scale (HAM-D), and patient rated Physical Health
Questionnaire (PHQ-9) and Generalised Anxiety Disorder 7 (GAD-7). The outcome
data of 144 patients with TRD was analysed. The sample included patients with
co-morbid psychiatric diagnosis. Results: Response and remission rates
respectively were 34.6% and 20.6% for the HAM-D; 10% and 28.6% for the PHQ-9;
31% and 31.8% for the CGI; and 24.6% and 28.8% for GAD-7. Effect sizes were
mostly medium (0.48, 0.27, 0.51, 0.43 respectively).
GAD-7 reliable change improvement was 56.1% and PHQ-9 reliable change
improvement was 40%. There was a medium positive correlation between anxiety
(GAD-7) and depression recovery (HAM-D), r = 0.31, n =
46, p = 0.039, with lower pre-treatment anxiety associated with lower post-treatment HAM-D scores. Conclusions: TRD
patients with low pre-treatment anxiety levels respond to treatment better than
those with high pre-treatment anxiety. The results show that a clinical rTMS
service can have a significant impact on symptoms of depression and anxiety in
TRD. The findings support wider availability of rTMS as a treatment option for
people with TRD.