Effect of prior pharmacotherapy on remission with sequential bilateral theta-burst versus standard bilateral repetitive transcranial magnetic stimulation in treatment-resistant late-life depression.

Wathra, Rafae A; Mulsant, Benoit H; Daskalakis, Zafiris J; Downar, Jonathan; McClintock, Shawn M; Nestor, Sean M; Rajji, Tarek K; Trevizol, Alisson P et al. · Br J Psychiatry · 2023

prospective_cohort · Level II

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Abstract

Repetitive transcranial magnetic stimulation (rTMS) is used for treatment of late-life depression. In the FOUR-D study, sequential bilateral theta-burst stimulation (TBS) had comparable remission rates to standard bilateral rTMS. Data were analysed from the FOUR-D trial to compare remission rates between two types of rTMS based on the number and class of prior medication trials. The remission rate was higher in participants with ≤1 previous trial (43.9%) than in participants with 2 previous trials (26.5%) or ≥3 previous trials (24.6%; χ² = 6.36, d.f. = 2, <i>P</i> = 0.04). Utilising rTMS earlier in late-life depression may lead to better outcomes.

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