Accelerated repetitive transcranial magnetic stimulation for treatment-resistant depression
Open accessAbstract
BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) has shown safety and efficacy for treatment-resistant depression, but requires daily treatment for 4-6 weeks. Accelerated TMS, with all treatments delivered over a few days, would have significant advantages in terms of access and patient acceptance. METHODS: Open-label accelerated TMS (aTMS), consisting of 15 rTMS sessions administered over 2 days, was tested in 14 depressed patients not responding to at least one antidepressant medication. Effects on depression, anxiety, and cognition were assessed the day following treatment, then after 3 and 6 weeks. RESULTS: No seizure activity was observed and only one patient had a serious adverse event (increased suicidal ideation). Two patients failed to complete a full course of aTMS treatments, and 36% did not complete all study visits. Depression and anxiety significantly decreased following aTMS treatments and improvements persisted 3 and 6 weeks later. Response rates immediately following treatment and at 3 and 6 weeks were 43, 36, and 36%, respectively. Remission rates at the same timepoints were 29, 36, and 29%. CONCLUSIONS: Accelerated TMS demonstrated an excellent safety profile with efficacy comparable to that achieved in daily rTMS in other trials. Limitations primarily include open-label treatment and a small sample size.
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There is some indication of increased adherence and faster treatment response for accelerated iTBS compared to conventional rTMS.
“with some indication of increased adherence and faster treatment response compared to conventional rTMS [22–25].”
From A phase I trial of accelerated intermittent theta burst rTMS for amnestic MCI (2024) · cites this paper as [23]
The Results (page unavailable) report a significant treatment effect by Day 3, consistent with an indication of faster response than a conventional multiweek rTMS course. But the Procedures describe accelerated 10 Hz rTMS, not accelerated iTBS, and the Results report two treatment discontinuations without showing increased adherence relative to conventional rTMS. (LLM, conf=0.88)
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- Authors
- Holtzheimer, P. E., McDonald, W. M., Mufti, M., Kelley, M. E., Quinn, S., Corso, G., & Epstein, C. M.
- Affiliations
- Emory University (US)
- Corresponding author
- Epstein, Charles M.
- Venue
- Depression and Anxiety
- Publisher
- Wiley
- Published
- 2010-08-23
- Volume
- 27
- Issue
- 10
- Pages
- 960-963
- ISSN
- 1091-4269 (ISSN-L)
- PMC
- PMC3020591
- OpenAlex
- W2143705402
- Cited by
- 204
- References
- 13
- Citations by year
- 2026: 14 · 2025: 19 · 2024: 18 · 2023: 9 · 2022: 15 · 2021: 19 · 2020: 17 · 2019: 9 · 2018: 15 · 2017: 14 · 2016: 7 · 2015: 11 · 2014: 11 · 2013: 7 · 2012: 9
- FWCI
- 5.04
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000454)
- National Institute of Mental Health (R01MH069886, K23MH077869)
- National Institute of Neurological Disorders and Stroke (R01NS046487)
- National Center for Research Resources (M01-RR00039, UL1RR025008, M01RR000039)
- National Center for Advancing Translational Sciences
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Keywords
- treatment-resistant depression, antidepressant-refractory depression, anxiety, cognitive function, seizure safety, suicidal ideation, remission rate, treatment response
- MeSH terms
- Adult, Aged, Antidepressive Agents, Combined Modality Therapy, Depression, Drug Resistance, Female, Follow-Up Studies, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Severity of Illness Index, Treatment Outcome, Transcranial Magnetic Stimulation, Young Adult
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