LAS VEGAS—Transcranial magnetic stimulation (TMS) is a viable treatment option for patients with major depressive disorder (MDD) and appears to be more effective for women than men, researchers reported at the 26th Annual U.S. Psychiatric and Mental Health Congress.
Randy Pardell, MD, DFAPA, Medical Director at Riverview Psychiatric & TMS Center of the Hudson Valley in Poughkeepsie, NY, conducted a retrospective chart review examining overall remission and response rates in 58 patients who experienced a major depressive episode. Patients had a median age of 55 and were treated with a median of 30 sessions of TMS (Neurostar).
Analysis indicated that overall, 72.4% of patients responded to TMS treatment, and 56.9% achieved remission as measured by the Hamilton Depression Rating Scale (HAMD-17). For women, the response rate was 77% and the remission rate was 71%. For men, these rates 65% and 61%, respectively. “We found that older people did not seem to do as well as younger people,” said Dr. Pardell. Seventy percent of patients 54 and younger responded to TMS treatment, compared with 61% of patients 55 and older.
Although the study did not assess the reason for this age disparity, Dr. Pardell suspects the aging brain may inhibit the effects of TMS. “As we get older, our brain shrinks,” he said. “As the brain shrinks, it increases the distance that the magnetic field has to go in order to stimulate the brain.”
In a separate retrospective study on TMS efficacy, Marilyn Vache, MD, Medical Director at Austin TMS Clinic for Depression, examined remission and response rates in 64 patients with moderate to severe MDD who had not responded to an average of 4.8 antidepressant trials. Approximately 66% of patients responded to TMS treatment, with 56% reaching remission.
These results exceeded Dr. Vache’s expectations, though she noted that, unlike in most clinical trials, in this study patients could continue to take antidepressants. “The next thing is to try to predict who the responders were,” she said. “I might break it out by motor threshold to see whether some people take more power than other to get an effect.”
Dr. Vache is also interested in the data on off-label treatment of bipolar disorder, bipolar depression, and anxiety. “There’s a lot more to learn,” she said. “It’s vey new and exciting.”