Clinical Repetitive Transcranial Magnetic Stimulation for Veterans with Major Depressive Disorder

TITLE
Clinical Repetitive Transcranial Magnetic Stimulation for Veterans with Major Depressive Disorder

AUTHORS
Kozel FA; Hernandez M; Van Trees K; Phillips S; Hashimie J; Weisman M; Obregon D; Sanchez DL; Catalano G; Schultz SK. Institution Kozel, F Andrew. Mental Health and Behavioral Sciences, James A. Haley Veterans’ Hospital, Tampa, FL, USA.

ELECTRONIC ADDRESS
frank.kozel@va.gov.

SOURCE
Annals of Clinical Psychiatry. 29(4):242-248, 2017 Nov.

BACKGROUND
Repetitive transcranial magnetic stimulation (TMS) is a relatively new treatment modality for patients with major depressive disorder (MDD). Numerous studies have demonstrated the efficacy of TMS for MDD in the general population. However, there is limited information regarding clinical outcomes among veterans receiving TMS for MDD.

METHODS
The clinical outcome and characteristics of all veterans with MDD who were treated with TMS as outpatients at the James A. Haley Veterans’ Hospital from October 2013 to December 2016 were assessed.

RESULTS
Among 40 patients who received TMS, there was a significant improvement of depressive symptoms using the Quick Inventory of Depressive Symptomatology-Self-Report (45% response, 20% remission) and the Montgomery-Asberg Depression Rating Scale (61.9% response, 42.9% remission). In addition to significant improvement in depressive symptoms, self-report of anxiety symptoms and function significantly improved. TMS was generally well tolerated, with only a small percentage of patients discontinuing treatment due to side effects. No seizures or persistent adverse effects were observed or reported.

CONCLUSIONS
TMS is an effective and well-tolerated option for MDD in a veteran population with significant treatment resistance and multiple comorbidities.