Back to Search Start Over

Concomitant medication use and clinical outcome of repetitive Transcranial Magnetic Stimulation (rTMS) treatment of Major Depressive Disorder.

Authors :
Hunter AM
Minzenberg MJ
Cook IA
Krantz DE
Levitt JG
Rotstein NM
Chawla SA
Leuchter AF
Source :
Brain and behavior [Brain Behav] 2019 May; Vol. 9 (5), pp. e01275. Date of Electronic Publication: 2019 Apr 02.
Publication Year :
2019

Abstract

Background: Repetitive Transcranial Magnetic Stimulation (rTMS) is commonly administered to Major Depressive Disorder (MDD) patients taking psychotropic medications, yet the effects on treatment outcomes remain unknown. We explored how concomitant medication use relates to clinical response to a standard course of rTMS.<br />Methods: Medications were tabulated for 181 MDD patients who underwent a six-week rTMS treatment course. All patients received 10 Hz rTMS administered to left dorsolateral prefrontal cortex (DLPFC), with 1 Hz administered to right DLPFC in patients with inadequate response to and/or intolerance of left-sided stimulation. Primary outcomes were change in Inventory of Depressive Symptomatology Self Report (IDS-SR30) total score after 2, 4, and 6 weeks.<br />Results: Use of benzodiazepines was associated with less improvement at week 2, whereas use of psychostimulants was associated with greater improvement at week 2 and across 6 weeks. These effects were significant controlling for baseline variables including age, overall symptom severity, and severity of anxiety symptoms. Response rates at week 6 were lower in benzodiazepine users versus non-users (16.4% vs. 35.5%, p = 0.008), and higher in psychostimulant users versus non-users (39.2% vs. 22.0%, p = 0.02).<br />Conclusions: Concomitant medication use may impact rTMS treatment outcome. While the differences reported here could be considered clinically significant, results were not corrected for multiple comparisons and findings should be replicated before clinicians incorporate the evidence into clinical practice. Prospective, hypothesis-based treatment studies will aid in determining causal relationships between medication treatments and outcome.<br /> (© 2019 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.)

Details

Language :
English
ISSN :
2162-3279
Volume :
9
Issue :
5
Database :
MEDLINE
Journal :
Brain and behavior
Publication Type :
Academic Journal
Accession number :
30941915
Full Text :
https://doi.org/10.1002/brb3.1275