Efficacy of repetitive transcranial magnetic stimulation in the treatment of depression with comorbid anxiety disorders

E, Clarke; P, Clarke; S, Gill; T, Paterson; L, Hahn; C, Galletly

Abstract:

Background The presence of comorbid anxiety is generally associated with poorer treatment outcomes in people with depression. Repetitive transcranial magnetic stimulation (rTMS) has been shown to be effective for treatment resistant depression, but there has been little research examining rTMS in depressed patients with comorbid anxiety disorders. This study aimed to investigate the efficacy of rTMS in patients with treatment resistant Major Depressive Disorder (MDD) and comorbid anxiety disorders. Methods This study included 248 patients with treatment resistant MDD who were treated with rTMS. Of these, 172 patients had one or more comorbid anxiety disorders, so their outcomes were compared with patients who did not have comorbid anxiety. Results Patients both with and without comorbid anxiety disorders showed improvement in depression ratings after rTMS treatment, with no significant difference in remission rates between groups. In those with comorbid anxiety disorders, 23.3% met criteria for remission and 39.5% met response criteria. For each anxiety disorder diagnosis, there was a significant reduction in HAM-A, HAM-D21, MADRS and ZUNG scores (p = <0.001 for all). Limitations This was not a sham-controlled study, so placebo response rates are not known. Patients were referred by private psychiatrists so are not representative of all patients with depression. Conclusion Our study indicates that rTMS is an effective treatment for Major Depressive Disorder in people who have comorbid anxiety disorders.

Patologie/Applicazioni:

• Depressione
• Stimolazione Magnetica Transcranica (TMS)
• Ansia (GAD)

Anno:

2019

Tipo di pubblicazione:

Articolo

Parola chiave:

TMS; Stimolazione magnetica transcranica; Ansia; Depressione

Testata scientifica:

Journal of Affective Disorders

Nota:

Questo studio indaga l'efficacia della rTMS (Stimolazione magnetica transcranica ripetitiva) in pazienti affetti da Disturbo Depressivo Maggiore (MDD), resistente ai trattamenti farmacologici, con sintomi d'ansia. Lo studio è stato condotto su 248 pazienti. Di questi, 172 pazienti avevano uno o più disturbi d'ansia in comorbidità, quindi i loro risultati sono stati confrontati con pazienti che non avevano ansia in comorbidità. I risultati hanno mostrato che la rTMS è un trattamento efficace per il disturbo depressivo maggiore nelle persone che hanno disturbi d'ansia in comorbidità.

DOI:

10.1016/j.jad.2019.03.085