We conducted an open trial to evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) in medication-resistant depression. This is the first study in Taiwan of rTMS for the treatment of depression.
A 2-week regimen of rTMS (100% of motor threshold, 5 Hz, 8 sec, 40 trains/20 min/day, 10 weekdays) applied to the left dorsolateral prefrontal cortex was administered to 11 patients with medication-resistant depression.
Ten subjects completed 2 weeks' treatment with rTMS. Scores on the 21-item Hamilton Depression Rating Scale (HAM-D21) and Beck Depression Inventory decreased by 48% and 28%, respectively. Five patients were clinical responders (≥ 50% reduction in HAM-D21 score): 2 of these were in complete remission (HAM-D21 score ≤ 7). Five patients were less responsive: 2 of these were partial responders (20-49% reduction in HAM-D21 score), whereas 3 did not improve. Younger versus older age was identified as a potential predictor of response to rTMS used as add-on therapy.
Our preliminary results indicate that rTMS can improve mood in patients with medication-resistant depression, and can also potentially replace electroconvulsive therapy for certain types of medication-resistant depression. Future double-blind, placebo-controlled trials of rTMS are warranted.