Srpski arhiv za celokupno lekarstvo 2014 Volume 142, Issue 5-6, Pages: 280-285
https://doi.org/10.2298/SARH1406280J
Full text ( 1458 KB)
Repetitive transcranial magnetic stimulation as an adjuvant method in the treatment of depression: Preliminary results
Jovičić Milica (School of Medicine, Belgrade)
Radovanović Saša (Institute for Medical Research, Belgrade)
Marić Nađa P. (School of Medicine, Belgrade + Clinical Center of Serbia, Clinic for Psychiatry, Belgrade)
Kostić Vladimir (School of Medicine, Belgrade + Clinical Center of Serbia, Clinic for Neurology, Belgrade)
Introduction. Repetitive transcranial magnetic stimulation (rTMS) is a method
of brain stimulation which is increasingly used in both clinical practice and
research. Up-to-date studies have pointed out a potential antidepressive
effect of rTMS, but definitive superiority over placebo has not yet been
confirmed. Objective. The aim of the study was to examine the effect of rTMS
as an adjuvant treatment with antidepressants during 18 weeks of evaluation
starting from the initial application of the protocol. Methods. Four patients
with the diagnosis of moderate/severe major depression were included in the
study. The protocol involved 2000 stimuli per day (rTMS frequency of 10 Hz,
intensity of 120% motor threshold) administered over the left dorsolateral
prefrontal cortex (DLPFC) for 15 days. Subjective and objective depressive
symptoms were measured before the initiation of rTMS and repeatedly evaluated
at week 3, 6, 12 and 18 from the beginning of the stimulation. Results. After
completion of rTMS protocol two patients demonstrated a reduction of
depressive symptoms that was sustained throughout the 15-week follow-up
period. One patient showed a tendency of remission during the first 12 weeks
of the study, but relapsed in week 18. One patient showed no significant
symptom reduction at any point of follow-up. Conclusion. Preliminary findings
suggest that rTMS has a good tolerability and can be efficient in
accelerating the effect of antidepressants, particularly in individuals with
shorter duration of depressive episodes and moderate symptom severity.
Keywords: transcranial magnetic stimulation, depression, antidepressants, HAMD
Projekat Ministarstva nauke Republike Srbije, br. III41029 i br. ON175090