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J ECT. 2009 Mar;25(1):44-9. doi: 10.1097/YCT.0b013e3181770237.

Repetitive transcranial magnetic stimulation for treatment of medication-resistant depression in older adults: a case series.

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  • 1Department of Psychiatry, Queen's University, 752 King Street West, Kingston, Ontario, Canada.


The antidepressant effects of repetitive transcranial magnetic stimulation (rTMS) are well documented, but studies to date have produced heterogeneous results in late-life depression.


To address this matter, we evaluated the efficacy of both high- and low-frequency rTMS delivered to the prefrontal cortex of older adults with treatment-resistant major depression.


Forty-nine older adults (69 +/- 6.7 years) with treatment-refractory major depressive disorders underwent a series of rTMS treatments as an adjuvant to pharmacotherapy. Patients received high-frequency rTMS delivered to the left dorsolateral prefrontal cortex, low-frequency stimulation to the right dorsolateral prefrontal cortex, or a combination thereof, at 80-110% of the motor threshold.


There was a modest, but statistically significant, mean reduction (24.7%) in Hamilton Depression Rating Scale (HDRS) scores from baseline to the end of treatment. Nine patients were classified as responders (50% HDRS reduction), and 4 patients reached remission status (final HDRS score <8). Similar improvements in HDRS scores were observed for high- and low-frequency rTMS. Treatment was generally well tolerated, and no serious adverse effects were reported.


The findings support the contention that in older adults with treatment-refractory depression, rTMS can be an effective treatment alternative for some patients.

[PubMed - indexed for MEDLINE]
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