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One Hundred Courses of Cluster Maintenance Transcranial Magnetic Stimulation (CM TMS)-A Clinical Audit Study.
- Source :
-
Psychopharmacology bulletin [Psychopharmacol Bull] 2022 Oct 27; Vol. 52 (4), pp. 61-68. - Publication Year :
- 2022
-
Abstract
- Objective: Major depressive disorder (MDD) which comes to transcranial magnetic stimulation (TMS) is prone to relapse. Cluster maintenance (CM) TMS is courses of 5 treatments delivered over 2.5-5 days, separated by monthly or greater non-treatment periods. Our aim was to characterize the outcomes of 100 courses of CM TMS.<br />Method: This was a Quality Assurance/Clinical Audit study. We studied consecutive CM TMS courses provided to private hospital inpatients. Mood was rated (on admission and discharge) using the six-item Hamilton depression rating (HAMD6) and the Clinical Global Impression - Severity (CGI-S) scales. We also applied recent STAR*D criteria which are designed to measure the 'clinical change' expected to impact patient function [16].<br />Results: For the total sample, using the HAMD6, 83% of courses featured relapse or partial relapse on admission, and 81% featured remission on discharge. Of 46 courses featuring HAMD6 relapse on admission, 74% featured remission on discharge. For the 100 courses the HAMD6 discharge scores were significantly lower than the admission scores (p = 2.0 × 10 <superscript>-24</superscript> ), as were the CGI-S scores (p = 1.8 × 10 <superscript>-25</superscript> ). Using STAR*D criteria for people in relapse or partial relapse on admission, CM TMS provided least a 'clinically meaningful' outcome in 82% of the cases.<br />Conclusion: For courses featuring relapse or partial relapse on admission, CM TMS converted greater than 70% to remission at discharge. It produced statistically significant reductions in HAMD6 and CGI-S scores, and using STAR*D criteria, at least 'clinically meaningful' change was extensively demonstrated. This evidence indicates CM TMS should be readily available to people living with relapsing MDD.<br /> (Copyright © 1964–2022 by MedWorks Media Inc, Los Angeles, CA All rights reserved. Printed in the United States.)
Details
- Language :
- English
- ISSN :
- 2472-2448
- Volume :
- 52
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Psychopharmacology bulletin
- Publication Type :
- Academic Journal
- Accession number :
- 36339276