Adjunctive use of repetitive transcranial magnetic stimulation in depressed adolescents: A prospective, open pilot study

Christopher A. Wall, Paul E Croarkin, Leslie A. Sim, Mustafa M. Husain, Philip G. Janicak, F. Andrew Kozel, Graham J. Emslie, Sheila M. Dowd, Shirlene M. Sampson

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Objective: Depression is often a serious and debilitating illness in adolescents. Unfortunately, a significant number of adolescents do not respond to antidepressant medications or psychotherapy. Repetitive transcranial magnetic stimulation (rTMS) is a novel treatment intervention shown to benefit depression in adults. This study considered rTMS as an adjunctive treatment in adolescents with major depressive disorder. Method: This prospective, open, multicenter trial of active adjunctive rTMS was conducted with 8 adolescents with DSM-IV-TR major depressive disorder (MDD) that had not responded sufficiently to 2 adequate antidepressant medication trials. All subjects were maintained on a stable dose of a selective serotonin reuptake inhibitor during the trial. Thirty daily rTMS treatments were given 5 days per week over 6 to 8 weeks. rTMS was applied to the left dorsolateral prefrontal cortex (120% of motor threshold; 10 Hz; 4-second trains; 26-second intertrain interval; 75 trains) for a total of 3,000 stimulations per treatment session. Results: Seven of 8 adolescents completed all 30 treatments. rTMS was well tolerated, and no significant safety issues were identified. Suicidal ideation was present at baseline in 3 of the adolescents, and it improved during treatment. The primary outcome measure was the Children's Depression Rating Scale-Revised (CDRS-R); results improved significantly from baseline (mean [SD]) (65.9 [6.6]) to treatment 10 (50.9 [12]), P < .02. The CDRS-R scores continued to improve through the rTMS treatment series at treatment 20 (40.1 [14]), P < .01; treatment 30 (32.6 [7.3]), P < .0001; and at 6-month follow-up (32.7 [3.8]), P < .0001. Conclusions: This prospective open trial suggests that rTMS is a safe, feasible, and potentially effective adjunctive therapy for treatment-resistant MDD in adolescents. Trial Registration: clinicaltrials.gov Identifier: NCT00587639.

Original languageEnglish (US)
Pages (from-to)1263-1269
Number of pages7
JournalJournal of Clinical Psychiatry
Volume72
Issue number9
DOIs
StatePublished - Sep 2011

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Transcranial Magnetic Stimulation
Major Depressive Disorder
Therapeutics
Depression
Antidepressive Agents
Treatment-Resistant Depressive Disorder
Suicidal Ideation
Serotonin Uptake Inhibitors
Prefrontal Cortex
Psychotherapy
Diagnostic and Statistical Manual of Mental Disorders
Multicenter Studies
Outcome Assessment (Health Care)
Safety

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Arts and Humanities (miscellaneous)

Cite this

Adjunctive use of repetitive transcranial magnetic stimulation in depressed adolescents : A prospective, open pilot study. / Wall, Christopher A.; Croarkin, Paul E; Sim, Leslie A.; Husain, Mustafa M.; Janicak, Philip G.; Kozel, F. Andrew; Emslie, Graham J.; Dowd, Sheila M.; Sampson, Shirlene M.

In: Journal of Clinical Psychiatry, Vol. 72, No. 9, 09.2011, p. 1263-1269.

Research output: Contribution to journalArticle

Wall, Christopher A. ; Croarkin, Paul E ; Sim, Leslie A. ; Husain, Mustafa M. ; Janicak, Philip G. ; Kozel, F. Andrew ; Emslie, Graham J. ; Dowd, Sheila M. ; Sampson, Shirlene M. / Adjunctive use of repetitive transcranial magnetic stimulation in depressed adolescents : A prospective, open pilot study. In: Journal of Clinical Psychiatry. 2011 ; Vol. 72, No. 9. pp. 1263-1269.
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AU - Wall, Christopher A.

AU - Croarkin, Paul E

AU - Sim, Leslie A.

AU - Husain, Mustafa M.

AU - Janicak, Philip G.

AU - Kozel, F. Andrew

AU - Emslie, Graham J.

AU - Dowd, Sheila M.

AU - Sampson, Shirlene M.

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