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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. milevr@providencecare.ca

Abstract

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

OBJECTIVE:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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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