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Background: Major depressive disorder (MDD) is frequently chronic and relapsing. The use of maintenance or continuation transcranial magnetic stimulation (TMS) has received clinical and some research support. Objective: To conduct a case series study to report the outcomes of once-weekly (OW) or once-fortnightly (OF) continuation TMS in a real-life setting. Methods: We offered OW or OF TMS sessions to patients with MDD in remission or partial remission/relapse. Results: Ten patients received OW TMS and four received OF TMS, for 8 to 46 weeks. No patients in either group who were in remission or partial remission at baseline experienced a relapse. Improvements in HAMD6 and CGI-S scores were statistically significant or of borderline significance for the total sample and the OW group. Conclusions: This naturalistic, open-label observational study indicates that OW TMS is effective as maintenance therapy in MDD, while also offering some support for OF TMS maintenance in preventing relapse. [ABSTRACT FROM AUTHOR]

This document, titled "TMS item number rules – what the evidence suggests," discusses the rules governing access to Medical Benefits Schedule item numbers for transcranial magnetic stimulation (TMS). The rules include restrictions on TMS rebates for patients who received TMS prior to November 2021, a lifetime limit of 50 TMS session rebates, and the exclusion of maintenance TMS from rebates. The document highlights the effectiveness of TMS in treating treatment-resistant depression (TRD) and the potential for relapse in patients taking antidepressant medication. It argues for the availability of TMS for all patients, the removal of the lifetime limit on TMS sessions, and the consideration of maintenance TMS as a treatment option. [Extracted from the article]

Objective: To examine reports of Transcranial Magnetic Stimulation (TMS) during pregnancy for evidence of fetal risk.Method: PubMed was used to locate relevant literature for the years 1998-2020 and reference lists were examined for materials not located electronically.Results: Ten reports were located dealing with 67 births over 20 years. Stimulation was applied is all trimesters, at low and high frequency, and as intermittent theta-burst stimulation. No mother or baby experienced a serious event.Conclusions: Certainty awaits large, standardized studies. However, the available reports provide no evidence that TMS to mother during pregnancy has detrimental effects on the fetus. [ABSTRACT FROM AUTHOR]

Objective: To determine the impact of clustered maintenance transcranial magnetic stimulation (TMS) on irritability occurring in treatment-resistant major depressive disorder (MDD).Method: A naturalistic study of 106 courses that includes pre- and posttreatment assessments of subjective and objective depression and a subjective measure of irritability developed for this study.Results: Forty-six participants (35 females), mean age 43.2 years (14.3), completed 106 courses. There was a significant reduction in irritability and depression scores (p < .001). The change in irritability scores was significantly correlated with the change in depression scores, r = .40, p < .001.Conclusion: TMS has the capacity to reduce the irritability co-occurring with treatment-resistant MDD, known to be responsive to TMS. This increases the possibility of using TMS in the treatment of irritability co-occurring with other disorders or standing alone (should irritability be categorized as a stand-alone disorder). [ABSTRACT FROM AUTHOR]

Background: Various TMS protocols have been described, none is appropriate in all circumstances. Objective: To describe the response of a person with acute MDD treated with TMS who was only available for treatment on 3 consecutive days per week. Method: 5 treatment sessions were provided over 3 days – this was provided 4 times, separated by no-treatment periods of 4 days. HAMD6, CSI-S and VAS for depression were completed on the first and last day of each 3-day treatment series. Results: Remarkable improvement; the HAMD6 fell from 12 (severe depression) to 0, the CGI-S fell from 5 (Markedly ill) to 1 (Normal, not mentally ill) and the VAS fell by 98%. There was clear improvement during the last 3 treatment series, as well as during all 3 no-treatment periods. Conclusion: Should these findings be replicated, an additional, useful protocol may be established. [ABSTRACT FROM AUTHOR]