PENATALAKSANAAN PASIEN DEPRESI MAYOR DI RSJ PROF. DR. SOEROYO MAGELANG DENGAN MENGGUNAKAN REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (rTMS)

Gangguan depresi mayor merupakan gangguan kejiwaan yang membawa dampak sangat buruk pada kehidupan penderita dan lingkungannya. Berbagai metode dikembangkan dalam memberikan penatalaksanaannya, seperti obat, psikoterapi, Electroconvulsive Therapy (ECT). Repetitive Transcranial Magnetic Stimulation saat ini dikembangkan sebagai salah satu alternative pengobatan gangguan depresi mayor. Pada penelitian ini digunakan Hamilton Rating Scale for Depression (HAM-D)

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Distinctive neurocognitive effects of repetitive transcranial magnetic stimulation and electroconvulsive therapy in major depression

The British Journal of Psychiatry ◽

10.1192/bjp.186.5.410 ◽

2005 ◽

Vol 186 (5) ◽

pp. 410-416 ◽

Cited By ~ 59

Author(s):

Svenja C. Schulze-Rauschenbach ◽

Uta Harms ◽

Thomas E. Schlaepfer ◽

Wolfgang Maier ◽

Peter Falkai ◽

...

Keyword(s):

Transcranial Magnetic Stimulation ◽

Major Depression ◽

Electroconvulsive Therapy ◽

Magnetic Stimulation ◽

Rating Scale ◽

Repetitive Transcranial Magnetic Stimulation ◽

Memory Complaints ◽

Treatment Of Depression ◽

Psychotic Major Depression ◽

Hamilton Rating Scale

BackgroundStudies have compared electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS) with regard to clinical efficacy in the treatment of depression, but no study has yet addressed the differential impact on cognition.AimsTo compare the neurocognitive effects of unilateral ECT and rTMS.MethodThirty patients with treatment-refractory non-psychotic major depression received an average of ten treatments with either unilateral ECT or left prefrontal rTMS and were assessed for objective and subjective cognitive impairments before and about a week after treatment.ResultsTreatment response was comparable (46% of the ECT group and 44% of the rTMS group showed a reduction of 50% or more in Hamilton Rating Scale for Depression scores). In patients treated with rTMS, cognitive performance remained constant or improved and memory complaints alleviated, whereas in the ECT group memory recall deficits emerged and memory complaints remained.ConclusionsIn contrastto unilateral ECT, rTMS has no adverse memory effects.

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Comparing the Effects of Repetitive Transcranial Magnetic Stimulation and Electroconvulsive Therapy in the Treatment of Depression: A Systematic Review and Meta-Analysis

Depression Research and Treatment ◽

10.1155/2014/135049 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 7

Author(s):

Beppe Micallef-Trigona

Keyword(s):

Transcranial Magnetic Stimulation ◽

Side Effects ◽

Electroconvulsive Therapy ◽

Magnetic Stimulation ◽

Rating Scale ◽

Repetitive Transcranial Magnetic Stimulation ◽

Meta Analysis ◽

Severe Depression ◽

Treatment Modalities ◽

Treatment Of Depression

Electroconvulsive therapy (ECT) is the longest standing psychiatric treatment available and has unequivocal benefit in severe depression. However this treatment comes with a number of side effects such as memory impairment. On the other hand, Repetitive Transcranial Magnetic Stimulation (rTMS) is a relatively new form of treatment which has been shown to be efficacious in patients suffering from a number of psychopathologies, including severe depression, with few reported side effects. Due to its potential therapeutic efficacy and lack of side effects, rTMS has gained traction in the treatment of depression, with a number of authors keen to see it take over from ECT. However, it is not clear whether rTMS represents a therapeutic alternative to ECT. This meta-analysis will therefore compare the “gold standard” treatment for severe depression, with the relatively new but promising rTMS. A literature search will be performed with the intention to include all randomised clinical trials. The null hypothesis is that there is no difference in the antidepressant efficacy between the two types of treatment modalities. Statistical analysis of Hamilton Depression Rating Scale (HDRS) scores will be performed.

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Treatment of Depression Using Sleep Electroencephalogram Modulated Repetitive Transcranial Magnetic Stimulation

European Psychiatry ◽

10.1016/s0924-9338(11)72847-4 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1142-1142

Author(s):

M. He ◽

Z. Gu ◽

X. Wang ◽

H. Shi

Keyword(s):

Transcranial Magnetic Stimulation ◽

Magnetic Stimulation ◽

Rating Scale ◽

Repetitive Transcranial Magnetic Stimulation ◽

Animal Experiments ◽

Treatment Of Depression ◽

Psychoactive Medication ◽

Before And After ◽

To Receive ◽

Hamilton Rating Scale

Background and purposeThe conventional repetitive transcranial magnetic stimulation (rTMS) has some inadequate of efficacy weak and inadequate for the treatment of depression, easy symptomatic recurrence when stop the treatment. Ours invented the device of sleep electroencephalogram-modulated rTMS (SEM-rTMS) were safe and effective by proved of the animal experiments and clinical pre-test for the treatment of depression. The purpose of this study was to examine the efficacy and safety of SEM-rTMS for the treatment of depression.MethodsAfter 7 days without psychoactive medication, 164 patients with clinically defined depression, were randomly assigned to receive SEM-rTMS (N = 57), conventional rTMS (C-rTMS (N = 55), or sham-rTMS (N = 52) for 30 minutes/time/day for 10 days. Before and after scores on the 24-item Hamilton rating scale for depression (HAMD-24) and the clinical outcome at the 10th-day of therapy for all subjects were analyzed.ResultsTwenty two cases in the SEM-rTMS group improved mood as compared to 6 in the C-rTMS group and 2 in the sham-rTMS group (c2 = 15.89, p = 0.0004). After completion of the rTMS phase of the protocol, a (51 ± 5) % reduction of HAMD-24 scores from the baseline in the SEM-rTMS group compared with a (34 ± 4)% in the C-rTMS group ((q = 26.09, p = 0.001) and a (14 ± 3)% in Sham-rTMS group (q = 57.53,p = 0.000). The 88% total efficacy ratio in the SEM-rTMS group was significant higher than 68% in the C-rTMS group and 20% in the sham-rTMS group (c2 = 12.01, p = 0.0025). No significant side effects were noted.ConclusionIt is efficient and safe to treat depression with repetitive transcranial magnetic stimulation. (The registration. No: ChiCTR-TRC-00000438).

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Repetitive transcranial magnetic stimulation as a maintenance therapy strategy after electroconvulsive therapy: a conceptual review

Revista Debates em Psiquiatria ◽

10.25118/2236-918x-6-4-1 ◽

2016 ◽

Vol Ano 6 ◽

pp. 6-13

Author(s):

Mercedes Jurema Oliveira Alves

Keyword(s):

Transcranial Magnetic Stimulation ◽

Maintenance Therapy ◽

Electroconvulsive Therapy ◽

Magnetic Stimulation ◽

Repetitive Transcranial Magnetic Stimulation ◽

Therapy Strategy

O presente texto faz uma revisão das bases teóricas e dos estudos empíricos disponíveis sobre o uso da estimulação magnética transcraniana de repetição como estratégia terapêutica de manutenção após eletroconvulsoterapia. Há quadros psiquiátricos pouco responsivos a quaisquer tipos de tratamentos, inclusive à eletroconvulsoterapia. O texto mostra que a combinação das técnicas é promissora, porém mais estudos são necessários para se definir as indicações precisas e a eficácia em termos de sustentação da resposta terapêutica.

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Repetitive transcranial magnetic stimulation treatment for peripartum depression: systematic review & meta-analysis

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03600-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hyune June Lee ◽

Sung Min Kim ◽

Ji Yean Kwon

Keyword(s):

Systematic Review ◽

Transcranial Magnetic Stimulation ◽

Side Effects ◽

Electroconvulsive Therapy ◽

Effect Size ◽

Magnetic Stimulation ◽

Repetitive Transcranial Magnetic Stimulation ◽

Meta Analysis ◽

Cochrane Library ◽

Peripartum Depression

Abstract Background Peripartum depression is a common disorder with very high potential hazards for both the patients and their babies. The typical treatment options include antidepressants and electroconvulsive therapy. However, these treatments do not ensure the safety of the fetus. Recently, repetitive transcranial magnetic stimulation has emerged as a promising treatment for neuropathies as well as depression. Nevertheless, many studies excluded pregnant women. This systematic review was conducted to confirm whether repetitive transcranial magnetic stimulation was a suitable treatment option for peripartum depression. Methods We performed a systematic review that followed the PRISMA guidelines. We searched for studies in the MEDLINE, PsycINFO, EMBASE, and Cochrane library databases published until the end of September 2020. Eleven studies were selected for the systematic review, and five studies were selected for quantitative synthesis. Data analysis was conducted using Comprehensive Meta-Analysis 3 software. The effect size was analyzed using the standardized mean difference, and the 95% confidence interval (CI) was determined by the generic inverse variance estimation method. Results The therapeutic effect size of repetitive transcranial magnetic stimulation for peripartum depression was 1.394 (95% CI: 0.944–1.843), and the sensitivity analysis effect size was 1.074 (95% CI: 0.689–1.459), indicating a significant effect. The side effect size of repetitive transcranial magnetic stimulation for peripartum depression was 0.346 (95% CI: 0.214–0.506), a meaningful result. There were no severe side effects to the mothers or fetuses. Conclusions From various perspectives, repetitive transcranial magnetic stimulation can be considered an alternative treatment to treat peripartum depression to avoid exposure of fetuses to drugs and the severe side effects of electroconvulsive therapy. Further research is required to increase confidence in the results.

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