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Repetitive transcranial magnetic stimulation: a putative add-on treatment for major depression in elderly patients

Lookup NU author(s): Dr Urs Mosimann

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Abstract

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 90degrees. 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. (C) 2004 Elsevier Ireland Ltd. All rights reserved.

Publication metadata

Author(s): Mosimann UP, Schmitt W, Greenberg BD, Kosel M, Muri RM, Berkhoff M, Hess CW, Fisch HU, Schlaepfer TE

Publication type: Article

Publication status: Published

Journal: Psychiatry Research

Year: 2004

Volume: 126

Issue: 2

Pages: 123-133

ISSN (print): 0165-1781

ISSN (electronic): 1872-7123

Publisher: Elsevier Ireland

URL: http://dx.doi.org/10.1016/j.psychres.2003.10.006

DOI: 10.1016/j.psychres.2003.10.006

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