Left prefrontal transcranial magnetic stimulation for treatment-resistant depression in adolescents: a double-blind, randomized, sham-controlled trial

Paul E. Croarkin, Ahmed Z. Elmaadawi, Scott T. Aaronson, G. Randolph Schrodt, Richard C. Holbert, Sarah Verdoliva, Karen L. Heart, Mark A. Demitrack, Jeffrey R. Strawn

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Treatment-resistant depression (TRD) is prevalent and associated with a substantial psychosocial burden and mortality. There are few prior studies of interventions for TRD in adolescents. This was the largest study to date examining the feasibility, safety, and efficacy of 10-Hz transcranial magnetic stimulation (TMS) for adolescents with TRD. Adolescents with TRD (aged 12–21 years) were enrolled in a randomized, sham-controlled trial of TMS across 13 sites. Treatment resistance was defined as an antidepressant treatment record level of 1 to 4 in a current episode of depression. Intention-to-treat patients (n = 103) included those randomly assigned to active NeuroStar TMS monotherapy (n = 48) or sham TMS (n = 55) for 30 daily treatments over 6 weeks. The primary outcome measure was change in the Hamilton Depression Rating Scale (HAM-D-24) score. After 6 weeks of blinded treatment, improvement in the least-squares mean (SE) HAM-D-24 scores were similar between the active (−11.1 [2.03]) and sham groups (−10.6 [2.00]; P = 0.8; difference [95% CI], − 0.5 [−4.2 to 3.3]). Response rates were 41.7% in the active group and 36.4% in the sham group (P = 0.6). Remission rates were 29.2% in the active group and 29.0% in the sham group (P = 0.95). There were no new tolerability or safety signals in adolescents. Although TMS treatment produced a clinically meaningful change in depressive symptom severity, this did not differ from sham treatment. Future studies should focus on strategies to reduce the placebo response and examine the optimal dosing of TMS for adolescents with TRD.

Original languageEnglish (US)
Pages (from-to)462-469
Number of pages8
JournalNeuropsychopharmacology
Volume46
Issue number2
DOIs
StatePublished - Jan 2021

ASJC Scopus subject areas

  • Pharmacology
  • Psychiatry and Mental health

Fingerprint

Dive into the research topics of 'Left prefrontal transcranial magnetic stimulation for treatment-resistant depression in adolescents: a double-blind, randomized, sham-controlled trial'. Together they form a unique fingerprint.

Cite this