TITLE
Impact of Repetitive Transcranial Magnetic Stimulation on Generalized Anxiety Disorder in Treatment-Resistant Depression
SOURCE
Annals of Clinical Psychiatry. 31(4):236-241, 2019 11.
AUTHORS
Griffiths C; O’Neill-Kerr A; De Vai R; da Silva K.
BACKGROUND
Published evidence indicates the value of repetitive transcranial magnetic stimulation (rTMS) for generalized anxiety disorder in patients with treatment-resistant depression (TRD). As a part of routine clinical service, patients with TRD received right dorsolateral prefrontal cortex (DLPFC) inhibitory rTMS immediately prior to left DLPFC depression treatment delivered according to a US Food and Drug Administration protocol.
METHODS
A retrospective investigation of routinely collected data between 2016 and 2018 was undertaken. Measures used were the clinician rated Clinical Global Impressions-Severity (CGI-S) scale and Hamilton Depression Rating scale (HAM-D), and the patient-rated Generalized Anxiety Disorder scale-7 (GAD-7) and Patient Health Questionnaire (PHQ-9). The outcome data of 61 patients with TRD were analyzed. The sample included patients with comorbid psychiatric diagnoses.
RESULTS
Response and remission rates, respectively, were 17.1% and 27.3% on the GAD-7; 20.7% and 12.5% on the HAM-D; 19% and 24% on the PHQ-9; and 20% and 23.5% on the CGI-S. Post-treatment scores significantly improved on the GAD-7, HAM-D, and CGI-S scales, with medium to large effect sizes (.61, .62, and .86 respectively).
CONCLUSIONS
Results indicate the potential value of rTMS in treating anxiety in patients who are referred for rTMS for TRD. Well-designed and adequately powered randomized controlled trials are required to determine clinical recommendations.
