61% of Unmedicated Treatment Resistant Depression Patients Who Did Not Respond to Acute TMS Treatment Responded After Four Weeks of Twice Weekly deep TMS in the BrainsWay Pivotal Trial

Journal: Brain Stimulation 10(4): 847-849 (2017)
Authors: A.G Yip, M.S George, A Tendler, Y Roth, A Zangen, L.L Carpenter

Background:

An acute course of dTMS typically involves treatments delivered 5 days a week, for 4 weeks.Should more treatments be given if the patient has not responded? Data are needed to inform decisions about the best next steps for acute non-responders.

Objective:

To characterize response among acute-phase non-responders in a randomized controlled trialof deep repetitive transcranial magnetic stimulation (dTMS) monotherapy for medication-resistant depression.

Methods:

Summary statistics and Kaplan-Meier curves were used to characterize outcomes of 33 medication-free BrainsWay dTMS non-responders to double blind but active treatment at the end of 4 weeks (20 sessions), who then continued double blind but active twice weekly treatment for up to 12 additional weeks.

Results:

24 participants (72.7%) achieved responder status during at least one rating with dTMS continuation -20 (60.6%) within four weeks, with 13 (39.4%) consistently meeting response criteria for the duration of the study. 20 (63.6%) achieved remission status at some point during treatment continuation.Conclusions:

A significant proportion of acute course non-responders to dTMS treatment eventually respond with continued treatment. Continuing TMS treatment beyond the acute course for non-responders may result in eventual response in over half of these individuals.