Deep TMS improves quality of life in treatment-resistant depression
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Key takeaways:
- Compared with sham, deep transcranial magnetic stimulation improved treatment-resistant major depressive disorder.
- It also improved patient-reported quality of life.
SAN FRANCISCO — For patients with treatment-resistant major depressive disorder, deep transcranial magnetic stimulation significantly improved symptoms and quality of life compared with sham, according to a poster presented here.
Aron Tendler, MD, chief medical officer of BrainsWay, a health technology company, presented the poster at the American Psychiatric Association annual meeting.
Tendler and colleagues enrolled 181 patients in a sham-controlled trial of deep transcranial magnetic stimulation (TMS) in patients with treatment-resistant major depressive disorder (MDD). Patients receiving deep TMS treatment underwent five sessions per week for 4 weeks, followed by two sessions per week for 12 weeks.
Scores on the Quality-of-Life Enjoyment and Satisfaction Questionnaire indicated that deep TMS significantly improved patient-reported quality of life compared with sham at week 5 (14.4 vs. 2.5; P = .0495) but not at week 16 (13.1 vs. 8.2).
Patients who had achieved at least a 50% reduction in Hamilton Depression Rating Scale (HDRS) score from baseline experienced a greater improvement in quality of life compared with patients who did not experience this reduction in HDRS score at both week 5 (P = .000005) and week 16 (P = .014).
Notably, 12% of patients who reported improved quality of life at week 5 sustained their improvement at week 16, while 47% improved even more, according to the poster.
“The implications relate to the concept of ‘recovery’ from depression,” Tendler told Healio. “Patients with good quality of life, enjoyment and satisfaction are meaningfully recovered. They are able to climb out from the ‘minus zone’ of depression and enter the ‘plus zone’ of productive life. They can fully engage in society, with their work and with their families and are no longer a ‘cost’ or ‘burden’ on society.
“We know the number of depressive residual symptoms correlates with time to relapse,” Tendler continued. “These patients who have a positive quality of life should also stay well for even longer. Practically, even though a course of deep TMS with the H1 coil for [patients with] treatment-resistant depression is more burdensome than just taking a pill, and even though direct comparisons to drugs are not possible in the absence of a head-to-head study, the data suggest that the outcomes achievable from deep TMS may make it worth a little more effort.”
Future research should compare matched cohorts of patients with treatment-resistant depression who underwent deep TMS or pharmacotherapy, Tendler said.