TMS Fails to Outperform Sham for Depression in Veterans
While 40% of US veterans experienced remission of treatment-resistant major depression after receiving repetitive transcranial magnetic stimulation (TMS), TMS failed to significantly outperform sham treatment in the study, which was published online in JAMA Psychiatry.
The remission rate for veterans with major depression who received sham treatment was 37.4%.
“These high remission rates suggest that veterans’ expectations of improvement and extensive attention provided by their TMS treatment team may have played a large role in the significant clinical improvements they experienced,” a Psychiatric News Alert report quoted from the study.
The double-blind clinical trial involved more than 160 US veterans with major depression who had not responded to 2 antidepressants. Some 81 were randomly assigned to receive left prefrontal TMS treatment (10 Hz, 120% motor threshold, 4,000 pulses/session), and 81 received sham TMS treatment for up to 30 treatment sessions.
Overall, researchers observed a 39% remission rate among participants, with no evidence of significant difference between active TMS and sham treatments.
“These findings may reflect the importance of close clinical surveillance, rigorous monitoring of concomitant medication, and regular interaction with clinic staff in bringing about significant improvement in this treatment-resistant population,” researchers concluded.
Yesavage JA, Fairchild JK, Mi Z, et al. Effect of repetitive transcranial magnetic stimulation on treatment-resistant major depression in US veterans: a randomized clinical trial. JAMA Psychiatry. 2018 June 27;[Epub ahead of print].