Agustin G Yip1, Mark S George2, Aron Tendler3, Yiftach Roth3, Abraham Zangen4, Linda L Carpenter5. 1. Butler Hospital, Providence, RI, United States; Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, United States. Electronic address: agustinyip@brown.edu. 2. Ralph H Johnson VA Medical Center, Charleston, SC, United States; Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States. 3. Brainsway Ltd, Jerusalem, Israel. 4. The Zlotoesky Neuroscience Center, Ben-Gurion University, Beer Shava, Israel. 5. Butler Hospital, Providence, RI, United States; Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, United States.
Abstract
BACKGROUND: An acute course of dTMS typically involves treatments delivered 5 days a week, for 4 weeks. Should more treatments be given if the patient has not responded? Data are needed to inform decisions about the best next steps for acute non-responders. OBJECTIVE: To characterize response among acute-phase non-responders in a randomized controlled trial of deep repetitive transcranial magnetic stimulation (dTMS) monotherapy for medication-resistant depression. METHODS: Summary statistics and Kaplan-Meier curves were used to characterize outcomes of 33 medication-free Brainsway™ dTMS non-responders to double blind but active treatment at the end of 4 weeks (20 sessions), who then continued double blind but active twice-weekly treatment for up to 12 additional weeks. RESULTS: 24 participants (72.7%) achieved responder status during at least one rating with dTMS continuation -- 20 (60.6%) within four weeks, with 13 (39.4%) consistently meeting response criteria for the duration of the study. 20 (63.6%) achieved remission status at some point during treatment continuation. CONCLUSIONS: A significant proportion of acute course non-responders to dTMS treatment eventually respond with continued treatment. Continuing TMS treatment beyond the acute course for non-responders may result in eventual response in over half of these individuals.
RCT Entities:
BACKGROUND: An acute course of dTMS typically involves treatments delivered 5 days a week, for 4 weeks. Should more treatments be given if the patient has not responded? Data are needed to inform decisions about the best next steps for acute non-responders. OBJECTIVE: To characterize response among acute-phase non-responders in a randomized controlled trial of deep repetitive transcranial magnetic stimulation (dTMS) monotherapy for medication-resistant depression. METHODS: Summary statistics and Kaplan-Meier curves were used to characterize outcomes of 33 medication-free Brainsway™ dTMS non-responders to double blind but active treatment at the end of 4 weeks (20 sessions), who then continued double blind but active twice-weekly treatment for up to 12 additional weeks. RESULTS: 24 participants (72.7%) achieved responder status during at least one rating with dTMS continuation -- 20 (60.6%) within four weeks, with 13 (39.4%) consistently meeting response criteria for the duration of the study. 20 (63.6%) achieved remission status at some point during treatment continuation. CONCLUSIONS: A significant proportion of acute course non-responders to dTMS treatment eventually respond with continued treatment. Continuing TMS treatment beyond the acute course for non-responders may result in eventual response in over half of these individuals.
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