TY - JOUR
T1 - Repetitive transcranial magnetic stimulation
T2 - A putative add-on treatment for major depression in elderly patients
AU - Mosimann, Urs P.
AU - Schmitt, Wolfgang
AU - Greenberg, Benjamin D.
AU - Kosel, Markus
AU - Müri, René M.
AU - Berkhoff, Magdalena
AU - Hess, Christian W.
AU - Fisch, Hans U.
AU - Schlaepfer, Thomas E.
N1 - Funding Information:
This project was funded by grants 4038-044046 and 3231-044523 from the Swiss National Science Foundation to Dr Schlaepfer.
PY - 2004/4/30
Y1 - 2004/4/30
N2 - Repetitive transcranial magnetic stimulation (rTMS) is a recent putative treatment for affective disorders. Several studies have demonstrated antidepressant effects of rTMS in younger patients; we aimed to assess its effect in older outpatients with treatment-resistant major depression. Twenty-four outpatients (mean age=62 years, S.D.=12) with major depression were randomized for sham or real stimulation and received 10 daily rTMS sessions (20 Hz, 2-s trains, 28-s intertrain intervals, 100% of motor threshold) in addition to the antidepressant medication. For sham stimulation, the coil was tilted 90°. Depression severity was assessed using the Hamilton Depression Rating Scale, the Beck Depression Inventory, items from the NIMH self-rated symptom scale, and a visual analog depression scale. Mini-Mental Status Examination performance, memory, and executive and attentional functions were measured to control for cognitive side effects. Depression ratings revealed significant antidepressant effects within 2 weeks in both sham and real stimulation groups; however, there were no between-group differences. Treatment with rTMS was safe; adverse events were rare and not more prevalent in either group, and cognitive assessment did not show any deterioration. We were unable to demonstrate any additional antidepressant effects of real stimulation in elderly patients with treatment-resistant major depression. Therapeutic effects of rTMS in this clinically challenging patient group remain to be demonstrated.
AB - Repetitive transcranial magnetic stimulation (rTMS) is a recent putative treatment for affective disorders. Several studies have demonstrated antidepressant effects of rTMS in younger patients; we aimed to assess its effect in older outpatients with treatment-resistant major depression. Twenty-four outpatients (mean age=62 years, S.D.=12) with major depression were randomized for sham or real stimulation and received 10 daily rTMS sessions (20 Hz, 2-s trains, 28-s intertrain intervals, 100% of motor threshold) in addition to the antidepressant medication. For sham stimulation, the coil was tilted 90°. Depression severity was assessed using the Hamilton Depression Rating Scale, the Beck Depression Inventory, items from the NIMH self-rated symptom scale, and a visual analog depression scale. Mini-Mental Status Examination performance, memory, and executive and attentional functions were measured to control for cognitive side effects. Depression ratings revealed significant antidepressant effects within 2 weeks in both sham and real stimulation groups; however, there were no between-group differences. Treatment with rTMS was safe; adverse events were rare and not more prevalent in either group, and cognitive assessment did not show any deterioration. We were unable to demonstrate any additional antidepressant effects of real stimulation in elderly patients with treatment-resistant major depression. Therapeutic effects of rTMS in this clinically challenging patient group remain to be demonstrated.
KW - Age
KW - Antidepressant treatment
KW - Cognition
KW - Geriatric depression
KW - Major depression
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U2 - 10.1016/j.psychres.2003.10.006
DO - 10.1016/j.psychres.2003.10.006
M3 - Article
C2 - 15123391
AN - SCOPUS:2342599040
SN - 0165-1781
VL - 126
SP - 123
EP - 133
JO - Psychiatry research
JF - Psychiatry research
IS - 2
ER -