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Long-Term Efficacy After Acute Augmentative Repetitive Transcranial Magnetic Stimulation in Bipolar Depression: A 1-Year Follow-Up Study

Dell'Osso, Bernardo MD; D'Urso, Nazario MD; Castellano, Filippo MD; Ciabatti, Mariateresa MD; Altamura, Alfredo Carlo MD

doi: 10.1097/YCT.0b013e3181f66601
Original Studies

Background: The efficacy of repetitive transcranial magnetic stimulation (rTMS) has been poorly investigated in the long-term. The present follow-up study was aimed to assess the long-term efficacy and the discontinuation effects of rTMS in a sample of depressed bipolar patients.

Methods: After the completion of an acute trial with augmentative, low-frequency, navigated rTMS, 11 drug-resistant depressed bipolar subjects (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [Text Revision] criteria) entered a naturalistic follow-up with monthly evaluations through the Hamilton Depression Rating Scale and the Young Mania Rating Scale.

Results: After 1 year of follow-up, results showed that the achievement of remission after acute rTMS was predictive of maintenance of response at 1 year. On the other hand, the absence of acute rTMS response predicted the absence of subsequent response in the long-term.

Conclusions: This first report on the long-term discontinuation effects after acute rTMS suggests that immediate remission is predictive of sustained benefit after 1 year. Larger controlled studies are needed to confirm present preliminary findings.

From the Department of Psychiatry, University of Milan, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy.

Received for publication May 13, 2010; accepted August 3, 2010.

Reprints: Bernardo Dell'Osso, MD, Department of Psychiatry, University of Milan, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy (e-mail: bernardo.dellosso@unimi.it).

© 2011 Lippincott Williams & Wilkins, Inc.