Clustered repetitive transcranial magnetic stimulation for the prevention of depressive relapse/recurrence: a randomized controlled trial

Repetitive transcranial magnetic stimulation (rTMS) may have the potential to prevent depressive relapse. This assessor-blinded, randomized controlled study was designed to evaluate the efficacy and safety of rTMS as a mono- and combination therapy in the prevention of depressive relapse/recurrence....

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Bibliographic Details
Published in:Translational psychiatry 2017-12, Vol.7 (12), p.1292-9, Article 1292
Main Authors: Wang, Hua-Ning, Wang, Xiao-Xia, Zhang, Rui-Guo, Wang, Ying, Cai, Min, Zhang, Ya-Hong, Sun, Run-Zhu, Guo, Li, Qiao, Yu-Ting, Liu, Jun-Chang, He, Hong, Wang, Zhong-Heng, Wan, Yu-Chen, Tan, Qing-Rong, Zhang, Zhang-Jin
Format: Article
Language:English
Subjects:
692/699/476/1333
692/699/476/1414
Adolescent
Adult
Antidepressive Agents - therapeutic use
Behavioral Sciences
Biological Psychology
Brief Communication
Combined Modality Therapy
Depressive Disorder, Major - drug therapy
Depressive Disorder, Major - prevention & control
Female
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Neurosciences
Pharmacotherapy
Psychiatry
Recurrence
Secondary Prevention
Transcranial magnetic stimulation
Transcranial Magnetic Stimulation - adverse effects
Transcranial Magnetic Stimulation - methods
Treatment Outcome
Young Adult
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Summary:Repetitive transcranial magnetic stimulation (rTMS) may have the potential to prevent depressive relapse. This assessor-blinded, randomized controlled study was designed to evaluate the efficacy and safety of rTMS as a mono- and combination therapy in the prevention of depressive relapse/recurrence. A total of 281 depressed patients who had achieved stable full or partial remission on a 6-month antidepressant (ADP) run-in treatment were randomly assigned to an rTMS ( n  = 91), ADP ( n  = 108), or combined (rTMS + ADP, n  = 82) treatment group for 12 months. Monthly clustered rTMS was conducted in 5–10 sessions over a 3–5-day period. Maintenance outcomes were assessed using time to relapse/recurrence and relapse/recurrence rate. Overall, 71.2% (200/281) of the participants completed the treatment per the protocol. rTMS + ADP and rTMS significantly reduced the risk of relapse/recurrence compared with ADP ( P  = 0.000), with hazard ratios of 0.297 and 0.466, respectively. Both rTMS-containing regimens produced significantly lower relapse/recurrence rates than ADP (15.9% and 24.2% vs. 44.4%, P  
ISSN:2158-3188
2158-3188
DOI:10.1038/s41398-017-0001-x