1. Psychotherapy and psychopharmacology utilization following repetitive transcranial magnetic stimulation (rTMS) in patients with major depressive disorder
- Author
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Jeffrey D. King, Stuart L. Lustig, Vikram N. Shah, Stephanie D. Mote, Priya Needs, Michael Manocchia, and Debra D. Szuba
- Subjects
Adult ,Male ,Psychotherapist ,Psychopharmacology ,medicine.medical_treatment ,Population ,Transcranial Direct Current Stimulation ,behavioral disciplines and activities ,03 medical and health sciences ,0302 clinical medicine ,mental disorders ,Medicine ,Humans ,Antipsychotic ,education ,Biological Psychiatry ,Depression (differential diagnoses) ,education.field_of_study ,Depressive Disorder, Major ,business.industry ,musculoskeletal, neural, and ocular physiology ,Middle Aged ,medicine.disease ,Transcranial Magnetic Stimulation ,Antidepressive Agents ,030227 psychiatry ,Transcranial magnetic stimulation ,Psychotherapy ,Psychiatry and Mental health ,Treatment Outcome ,nervous system ,Major depressive disorder ,Antidepressant ,Population study ,Female ,business ,psychological phenomena and processes ,030217 neurology & neurosurgery ,Antipsychotic Agents - Abstract
Lifetime prevalence of major depressive disorder (MDD) among a sample of adults in the United States has been reported as over 16%. Repetitive transcranial magnetic stimulation (rTMS) has become a treatment option for a subset of treatment-refractory patients with MDD. In a population of 159 commercial health plan individuals, we used claims data to compare utilization of antidepressants, antipsychotics, and psychotherapy during the one-year time period prior to rTMS initiation to the one-year time period starting 60 days after rTMS initiation. Both antidepressant and antipsychotic use declined significantly from three months pre-rTMS compared to each of four quarterly post-rTMS time points. Psychotherapy utilization also significantly declined post-rTMS compared to pre-rTMS. The reduction in medication utilization could reflect clinical improvement of the study population, and the absence of even greater reductions in utilization likely reflects the lack of clinical guidelines for antidepressant prescribing in the aftermath of rTMS treatment.
- Published
- 2019