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J Affect Disord. 2013 Oct;151(1):129-35. doi: 10.1016/j.jad.2013.05.062. Epub 2013 Jun 18.

Maintenance transcranial magnetic stimulation reduces depression relapse: a propensity-adjusted analysis.

Author information

1
Department of Psychiatry, Sainte-Marguerite University Hospital, 13009 Marseille, France. raphaellemarie.richieri@ap-hm.fr

Abstract

BACKGROUND:

The effectiveness of repetitive transcranial magnetic stimulation (TMS) is well established while studies of maintenance TMS are lacking. We aim here to determine whether maintenance is associated to a decrease in the relapse rate of depression, following successful acute treatment.

METHODS:

We enrolled 59 consecutive patients with pharmacoresistant depression who have responded (>50% decrease in symptom severity) up to 6 weeks of acute TMS treatment. These patients received either 20 weeks of maintenance TMS (n=37) or no additional TMS treatment (n=22). We performed propensity adjusted-analysis to examine the association between the relapse rate over this 20-week period and maintenance TMS. Propensity analysis eliminated differences in baseline characteristics between patient with and without maintenance TMS and approximated the conditions of random site-of-treatment assignment.

RESULTS:

At 20 weeks, relapse rate was significantly different between the two groups (p=0.004, propensity analysis): 14 patients in the maintenance TMS group (37.8%) vs. 18 in the non-maintenance TMS group (81.8%), with an adjusted Hazard Ratio (HR)=0.288 (0.124-0.669).

CONCLUSIONS:

Maintenance TMS was associated with a significantly lower relapse rate in patients with pharmacoresistant depression in routine practice among responders.

KEYWORDS:

Depression; Maintenance treatment; Repetitive transcranial magnetic stimulation

PMID:
23790811
DOI:
10.1016/j.jad.2013.05.062
[Indexed for MEDLINE]

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