1. Psychostimulant use and clinical outcome of repetitive transcranial magnetic stimulation treatment of major depressive disorder
- Author
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Wilke, Scott A, Johnson, Crystal L, Corlier, Juliana, Marder, Katharine G, Wilson, Andrew C, Pleman, Christopher M, and Leuchter, Andrew F
- Subjects
Biological Psychology ,Biomedical and Clinical Sciences ,Clinical Sciences ,Psychology ,Behavioral and Social Science ,Clinical Research ,Serious Mental Illness ,Depression ,Clinical Trials and Supportive Activities ,Rehabilitation ,Mental Health ,Brain Disorders ,5.1 Pharmaceuticals ,Development of treatments and therapeutic interventions ,Mental health ,Depressive Disorder ,Major ,Humans ,Prefrontal Cortex ,Prospective Studies ,Transcranial Magnetic Stimulation ,Treatment Outcome ,brain stimulation ,dopamine ,major depressive disorder ,monoamines ,norepinephrine ,psychostimulants ,repetitive transcranial magnetic stimulation ,Psychiatry ,Clinical sciences ,Clinical and health psychology ,Social and personality psychology - Abstract
BackgroundRepetitive transcranial magnetic stimulation (rTMS) is an effective treatment for major depressive disorder (MDD). Psychostimulant medication use may be associated with improved rTMS outcomes, but a detailed understanding of these relationships is lacking.MethodsWe compared MDD subjects taking psychostimulants (n = 37) with those not taking one of these medications (n = 53) during a course of 30 rTMS treatments. Changes in the 30-item Inventory of Depressive Symptomatology Self Report (IDS-SR30) subscale scores were examined at treatment 30. We also subdivided subjects into three categories based on drug mechanism and looked at IDS-SR30 total score after treatments 10, 20, and 30.ResultsSubjects taking psychostimulants had a significantly greater overall clinical improvement than those not taking these medications at treatment 30. The psychostimulant group also improved significantly more than the control group in "sleep" and "mood/cognition," but not "anxiety/arousal" IDS-SR30 subscales. No differences were detected among individual drug categories, which may reflect the limited sample size for individual medications. There was a negative dose-response relationship for the lisdexamfetamine/dextroamphetamine group, in which lower doses were associated with better clinical outcome.ConclusionsPsychostimulant medications may enhance clinical efficacy of rTMS for MDD by preferentially impacting specific symptom domains. For some psychostimulants, these effects may be dose-dependent. Prospective clinical trials are needed to guide psychostimulant augmentation of brain stimulation therapies. more...
- Published
- 2022