Unlocking Hope: The Superior Efficacy of rTMS for Treatment-Resistant Depression
Major Finding
This study demonstrates the optimal effectiveness of Transcranial Magnetic Stimulation (rTMS) for individuals who have Major Depressive Disorder and who have been resistant to previous treatments. Specifically, rTMS demonstrated superiority over switching to Venlafaxine or augmentation with Abilify.
Cool Fact
Our clinic, Westside NeuroTherapeutics, was a data collection site for this Harvard-led study, with our own Dr. Alexander Bystritsky as the PI (Primary Investigator).
Let's Take a Closer Look
The study evaluated three different treatment plans and measured which of the three were most effective in reducing depressive symptoms. The treatment plans included augmentation with aripiprazole, repetitive Transcranial Magnetic Stimulation (rTMS) augmentation, and switching to venlafaxine XR.
The Problem
For individuals who struggle with Major Depressive Disorder, there are many different treatment options to lessen the impact of their symptoms on their daily life and well-being. However, for individuals struggling with Treatment-Resistant Depression (TRD), the standard treatment plans are not effective, leaving individuals with TRD feeling hopeless, lost, and even more symptomatic than before.
The Solution
Transcranial Magnetic Stimulation (TMS) offers a non-invasive brain stimulation therapy that has shown promise in treating symptoms of depression, particularly in those who have not responded to traditional treatments. TMS works by using magnetic fields to stimulate nerve cells in the brain involved in mood control.
The Study
The study evaluated three different treatment plans:
Aripiprazole (Abilify) Augmentation: This group received a dose of aripiprazole in addition to their existing antidepressant treatment.
Repetitive Transcranial Magnetic Stimulation (rTMS) Augmentation: This group received rTMS treatment in addition to their existing antidepressant treatment.
Venlafaxine XR (Effexor) Switch: This group completely stopped their current antidepressant and started a new medication, venlafaxine XR.
The Results
The study used the Montgomery-Asberg Depression Rating Scale (MADRS) to evaluate the reduction in depressive symptoms after the 8-week trial period ended. The results showed a greater reduction in depressive symptoms in the rTMS augmentation group compared to the venlafaxine XR switch group. The difference in mean MADRS reduction was 4.17 points, indicating a statistically significant change. Additionally, the number needed to treat (NNT) for response and remission rates favored rTMS augmentation over aripiprazole augmentation and venlafaxine XR switch. There were no statistically significant differences in treatment efficacy between aripiprazole augmentation and switching to venlafaxine XR.
The Conclusion
In conclusion, this scientific study shows that rTMS augmentation, combining rTMS treatment with the patient’s current antidepressant medication, is more effective than switching to venlafaxine XR in treating symptoms of depression in Treatment-Resistant Depression. Additionally, aripiprazole augmentation proved to be more effective than switching to venlafaxine but not as effective as rTMS augmentation. rTMS augmentation may be the breakthrough needed for individuals struggling with Treatment-Resistant Depression who have exhausted other medication and treatment options.
Citations: Brainsway https://www.brainsway.com