scholarly journals Repetitive Transcranial Magnetic Stimulation (rTMS) for depression: outcomes in a United Kingdom (UK) clinical practice

2018 ◽  
Vol 11 (6) ◽  
pp. e9
Author(s):  
Chris Griffiths ◽  
Alex O'Neill-Kerr ◽  
Timothy Millward ◽  
Ksenija Da Silva
Keyword(s):  
United Kingdom ◽  
Clinical Practice ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation

Transcranial magnetic stimulation (TMS) safety: a practical guide for psychiatrists

2018 ◽  
Vol 26 (2) ◽  
pp. 189-192 ◽  
Author(s):  
Rohan Taylor ◽  
Veronica Galvez ◽  
Colleen Loo
Keyword(s):  
Older Adults ◽  
Clinical Practice ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Local Pain ◽  
Safety Issues ◽  
Assessment And Monitoring ◽  
Monitoring Treatment ◽  
Site Of Stimulation

Objectives: Repetitive transcranial magnetic stimulation (rTMS) is increasingly being utilised as a treatment option for depression, and with this comes a need for a practical review of safety issues intended for clinicians. This article provides an overview of the current literature regarding safety issues with rTMS for depression, and provides recommendations for clinical practice. Conclusions: Overall, rTMS is a well-tolerated treatment with common side effects (such as headache or local pain at the site of stimulation) being mild. Severe adverse effects, such as seizures, hearing impairment or mania, are uncommon. Certain populations, including adolescents, pregnant women, older adults and those with metal/electronic implants, require special consideration when prescribing and monitoring treatment courses. With adequate assessment and monitoring processes, rTMS can be administered safely in a large proportion of depressed patients.

scholarly journals Repetitive transcranial magnetic stimulation (rTMS) using different TMS instruments for major depressive disorder at a suburban tertiary clinic

2019 ◽  
Vol 11 (1) ◽  
pp. 1-8
Author(s):  
Maria Cristina Davila ◽  
Brianna Ely ◽  
Ann M. Manzardo
Keyword(s):  
Major Depressive Disorder ◽  
Clinical Practice ◽  
Transcranial Magnetic Stimulation ◽  
Depressive Disorder ◽  
Clinical Response ◽  
Magnetic Stimulation ◽  
Suicide Attempts ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Major Depressive ◽  
Remission Rates

Repetitive transcranial magnetic stimulation (rTMS) is a neurostimulatory technique used to modulate orbital frontal corticostriatal (OFC) activity and clinical symptomatology for psychiatric disorders involving OFC dysfunction. We examined the effectiveness of rTMS in the treatment of major depressive disorder in an applied clinical setting (Awakening KC CNI) to assess efficacy and optimize rTMS parameters within clinical practice. A retrospective review of medical records was carried out on patients with major depressive disorder undergoing rTMS therapy at Awakenings KC Clinical Neuroscience Institute (CNI), a suburban tertiary psychiatric clinic. A detailed de-identified data set of clinical outcomes was compiled. Patient Health Questionnaire 9 (PHQ-9) total score, clinical remission rate and week achieved were evaluated over 6 weeks of treatment to assess clinical response referencing two different rTMS instruments (MagVenture; NeuroStar). Our survey included 247 participants from males (N=98) and females (N=149) with average baseline PHQ-9 scores of 21.7±4, classified as severe depression. Clinically rated remission rates of 72% were achieved in 3.1±1.0 weeks and associated with prior history of psychiatric hospitalization, suicide attempts and substance use disorder. Average baseline PHQ-9 scores decreased significantly over time with proportionately greater remission rates achieved for patients treated using the MagVenture over NeuroStar instrument. rTMS in applied clinical practice is efficacious over a wide range of settings and patients. Clinical response was related to severity of depression symptoms (e.g., prior hospitalization; suicide attempts) validating efficacy in critically ill groups. Clinical response may be impacted by rTMS instrument, magnetic field parameters or individual factors.

scholarly journals Time to remission analysis for major depressive disorder after repetitive transcranial magnetic stimulation (rTMS)

2019 ◽  
Vol 11 (1) ◽  
pp. 26-30
Author(s):  
Ann M. Manzardo ◽  
Brianna Ely ◽  
Maria Cristina Davila
Keyword(s):  
Magnetic Field ◽  
Major Depressive Disorder ◽  
Clinical Practice ◽  
Transcranial Magnetic Stimulation ◽  
Depressive Disorder ◽  
Magnetic Stimulation ◽  
Psychiatric Hospitalization ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Individual Factors ◽  
Major Depressive

We previously examined the efficacy of rTMS for major depressive disorder in an applied clinical practice. Clinical response was related to severity of depression as well as the rTMS instrument utilized suggesting a relationship to instrument or magnetic field parameters and individual factors. The effectiveness of repetitive transcranial magnetic stimulation (rTMS) in the treatment of major depressive disorder was further evaluated using Log-Rank statistics for time to remission outcomes. A follow-up retrospective medical records study was carried out on patients with major depressive disorder undergoing rTMS therapy at AwakeningsKC Clinical Neuroscience Institute (CNI), a suburban tertiary psychiatric clinic. Cox Proportional Hazard with Log-Rank statistics were applied and the time course to clinical remission was evaluated over a 6-week period with respect to age, gender, and depression severity. Clinical response was observed referencing two different rTMS instruments (MagVenture; NeuroStar). Time to remission studies of 247 case reports (N=98 males; N=149 females) showed consistently greater clinically defined remission rates after 6 weeks of rTMS treatment for patients using the MagVenture vs NeuroStar instrument. Patients previously admitted for inpatient psychiatric hospitalization exhibited higher response rates when treated with the MagVenture rTMS unit. Stepwise Cox Proportional Hazards Regression final model of time to remission included rTMS unit, inpatient psychiatric hospitalization and obese body habitus. Response to rTMS in applied clinical practice is related to severity of psychiatric illness and may require consideration of magnetic field parameters of the rTMS unit with respect to individual factors such as sex or body composition.

The place of non-invasive brain stimulation in the RANZCP clinical practice guidelines for mood disorders

2021 ◽  
Vol 55 (4) ◽  
pp. 349-354
Author(s):  
Paul B Fitzgerald ◽  
Shane Gill ◽  
Salam Hussain ◽  
Shanthi Sarma ◽  
Suneel Chamoli ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Transcranial Magnetic Stimulation ◽  
Mood Disorders ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Antidepressant Use

Clinical practice guidelines are important documents as they have the capacity to significantly influence and shape clinical practice in important areas of therapeutics. As such, they need to be developed informed by comprehensive and quality-based systematic reviews, involve consensus deliberations representative of the appropriate experts in the field and be subject to thorough critical review. A revised clinical practice guideline for the management of patients with mood disorders was recently published under the auspices of the Royal Australian and New Zealand College of Psychiatrists. However, this clinical practice guideline was not developed in a manner that reflects the appropriate standards that should apply to clinical practice guideline development and it has critical flaws, especially as it pertains to the use of repetitive transcranial magnetic stimulation treatment for patients with depression. The revision of the college clinical practice guideline has explicitly removed clear and unequivocal evidence-based recommendations that were found in a previous version of the clinical practice guideline and replaced these with consensus-based recommendations. However, the consensus-based recommendations were developed without consultation of the appropriate expert body within the college and contradict the scientific literature. There is substantive and unequivocal evidence supporting the antidepressant use of repetitive transcranial magnetic stimulation in the treatment of patients with depression and its use after a patient with depression has failed a limited number (typically around two) of antidepressant medication trials. Readers should refer to the college Professional Practice Guidelines for repetitive transcranial magnetic stimulation published in 2018 for thorough information about the use of this important new treatment.

scholarly journals Correction to: Current clinical practice of electroconvulsive therapy and repetitive transcranial magnetic stimulation in psychiatry, a German sample

2021 ◽  
Author(s):  
Charles Timäus ◽  
Jonathan Vogelgsang ◽  
Bernhard Kis ◽  
Katrin Radenbach ◽  
Claus Wolff-Menzler ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Transcranial Magnetic Stimulation ◽  
Electroconvulsive Therapy ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Current Clinical Practice ◽  
German Sample

A correction to this paper has been published: https://doi.org/10.1007/s00406-021-01275-7

scholarly journals Repetitive transcranial magnetic stimulation (rTMS) using different TMS instruments for major depressive disorder at a suburban tertiary clinic

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Maria Cristina Davila ◽  
Brianna Ely ◽  
Ann M. Manzardo
Keyword(s):  
Major Depressive Disorder ◽  
Clinical Practice ◽  
Transcranial Magnetic Stimulation ◽  
Depressive Disorder ◽  
Clinical Response ◽  
Magnetic Stimulation ◽  
Suicide Attempts ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Major Depressive ◽  
Remission Rates

Repetitive transcranial magnetic stimulation (rTMS) is a neurostimulatory technique used to modulate orbital frontal corticostriatal (OFC) activity and clinical symptomatology for psychiatric disorders involving OFC dysfunction. We examined the effectiveness of rTMS in the treatment of major depressive disorder in an applied clinical setting (Awakening KC CNI) to assess efficacy and optimize rTMS parameters within clinical practice. A retrospective review of medical records was carried out on patients with major depressive disorder undergoing rTMS therapy at Awakenings KC Clinical Neuroscience Institute (CNI), a suburban tertiary psychiatric clinic. A detailed de-identified data set of clinical outcomes was compiled. Patient Health Questionnaire 9 (PHQ-9) total score, clinical remission rate and week achieved were evaluated over 6 weeks of treatment to assess clinical response referencing two different rTMS instruments (MagVenture; NeuroStar). Our survey included 247 participants from males (N=98) and females (N=149) with average baseline PHQ-9 scores of 21.7±4, classified as severe depression. Clinically rated remission rates of 72% were achieved in 3.1±1.0 weeks and associated with prior history of psychiatric hospitalization, suicide attempts and substance use disorder. Average baseline PHQ- 9 scores decreased significantly over time with proportionately greater remission rates achieved for patients treated using the MagVenture over NeuroStar instrument. rTMS in applied clinical practice is efficacious over a wide range of settings and patients. Clinical response was related to severity of depression symptoms (e.g., prior hospitalization; suicide attempts) validating efficacy in critically ill groups. Clinical response may be impacted by rTMS instru- ment, magnetic field parameters or individual factors.

scholarly journals Time to remission analysis for major depressive disorder after repetitive transcranial magnetic stimulation (rTMS)

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Ann M. Manzardo ◽  
Brianna Ely ◽  
Maria Cristina Davila
Keyword(s):  
Magnetic Field ◽  
Major Depressive Disorder ◽  
Clinical Practice ◽  
Transcranial Magnetic Stimulation ◽  
Depressive Disorder ◽  
Magnetic Stimulation ◽  
Psychiatric Hospitalization ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Individual Factors ◽  
Major Depressive

We previously examined the efficacy of rTMS for major depressive disorder in an applied clinical practice. Clinical response was related to severity of depression as well as the rTMS instrument utilized suggesting a relationship to instrument or magnetic field parameters and individual factors. The effectiveness of repetitive transcranial magnetic stimulation (rTMS) in the treatment of major depressive disorder was further evaluated using Log-Rank statistics for time to remission outcomes. A follow-up retrospective medical records study was carried out on patients with major depressive disorder undergoing rTMS therapy at AwakeningsKC Clinical Neuroscience Institute (CNI), a suburban tertiary psychiatric clinic. Cox Proportional Hazard with Log-Rank statistics were applied and the time course to clinical remission was evaluated over a 6-week period with respect to age, gender, and depression severity. Clinical response was observed referencing two different rTMS instruments (MagVenture; NeuroStar). Time to remission studies of 247 case reports (N=98 males; N=149 females) showed consistently greater clinically defined remission rates after 6 weeks of rTMS treatment for patients using the MagVenture vs NeuroStar instrument. Patients previously admitted for inpatient psychiatric hospitalization exhibited higher response rates when treated with the MagVenture rTMS unit. Stepwise Cox Proportional Hazards Regression final model of time to remission included rTMS unit, inpatient psychiatric hospitalization and obese body habitus. Response to rTMS in applied clinical practice is related to severity of psychiatric illness and may require consideration of magnetic field parameters of the rTMS unit with respect to individual factors such as sex or body composition.

Sign in / Sign up

Export Citation Format

Share Document