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Second Courses of Transcranial Magnetic Stimulation (TMS) in Major Depressive Episodes for Initial Responders and Non- Responders
Pridmore, Saxby; Erger, Sheila & May, Tamara
Abstract
Background: Transcranial Magnetic Stimulation (TMS) is effective in major depressive
episodes (MDE). However, MDE may follow a chronic, relapsing course, and some individuals may
not satisfactorily respond to a first course of TMS.
Objective: To investigate the outcome of second courses of TMS.
Method: A naturalistic investigation—we prospectively studied 30 MDE in-patients
and routinely collected information, including pre- and post-treatment with Six-item Hamilton
Depression Rating Scale (HAMD6), a six-item Visual Analogue Scale (VAS6) and the Clinical
Global Impression-Severity (CGI-S). Two categories of patients were considered: i) those who had
remitted with a first course, but relapsed, and ii) those who had not remitted with the first course.
Results: Thirty individuals received a second TMS course. The mean time to the second
course was 27.5 weeks. Based on the HAMD6, 26 (87%) achieved remission after the first course,
and 22 (73%) achieved remission after the second course. Furthermore, based on the HAMD6
results, of the four patients who did not achieve remission with a first course, three (75%) did so
with a second course.
Conclusion: In MDE, a second course of TMS is likely to help those who remitted to a first
course and then relapsed, as well as those who did not achieve remission with a first course.
Keywords
transcranial magnetic stimulation; depression; neurostimulation
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