Accelerated repetitive transcranial magnetic stimulation in the treatment of depressive disorder resistant to a course of antidepressant medication

Abstract Aims It is generally known that 30% of Major depressive disorder (MDD) patients do not respond to traditional pharmacological and psychosocial therapy. Transcranial magnetic stimulation (TMS), introduced first in 1985, was a non-invasive neural network research method. Later, repetitive Tra...

Full description

Saved in:
Bibliographic Details
Main Authors: Mahtab Motamed, Azin Fathi, Arman Hajikarim-Hamedani, Javad Alaghband-rad
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Annals of General Psychiatry
Subjects:
Online Access:https://doi.org/10.1186/s12991-025-00572-y
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849325841664704512
author Mahtab Motamed
Azin Fathi
Arman Hajikarim-Hamedani
Javad Alaghband-rad
author_facet Mahtab Motamed
Azin Fathi
Arman Hajikarim-Hamedani
Javad Alaghband-rad
author_sort Mahtab Motamed
collection DOAJ
description Abstract Aims It is generally known that 30% of Major depressive disorder (MDD) patients do not respond to traditional pharmacological and psychosocial therapy. Transcranial magnetic stimulation (TMS), introduced first in 1985, was a non-invasive neural network research method. Later, repetitive Transcranial Magnetic Stimulation (rTMS) was approved by the FDA to treat treatment-resistant depression (TRD) in 2008. Over the past two decades, rTMS has been extensively developed using various protocols in order to stimulate superficial brain nerve cells non-invasively. We planned to see if high-frequency accelerated left prefrontal rTMS can improve symptoms of treatment resistant depression given its convenience it provides by having patients for fewer treatment sessions. Methods A total of 25 patients were enrolled in the study. Inclusion criteria were age between 18 and 60 and a history of at least one failed treatment with antidepressants. The treatment was conducted over six days scattered over three weeks and each day consisted of three 30-minute sessions (83, 83, and 84 trains for each session). The sessions were separated with 15-minute breaks. rTMS protocol: 120% of the motor threshold and frequency of 10 Hz. Consisting of 2.4 s trains with an intertrain interval of 15-seconds. Result The study included 25 individuals (male: 12/13) with an average age of 36.88 ± 10.61. We compared outcome indicators at baseline and week three after confirming the normality of the data. After three weeks, Hamilton Depression Rating Scale and Clinician Global Impression showed a substantial improvement. There was a remission rate of 24% (6/25) and a response rate of 52% (13/25). Conclusion This work adds to the evidence that rTMS can treat TRD and shows that a more convenient high-frequency accelerated rTMS can improve symptoms in treatment resistant depression. Graphical Abstract
format Article
id doaj-art-e07ab7d2cd024726a0e40488564fbd17
institution Kabale University
issn 1744-859X
language English
publishDate 2025-05-01
publisher BMC
record_format Article
series Annals of General Psychiatry
spelling doaj-art-e07ab7d2cd024726a0e40488564fbd172025-08-20T03:48:18ZengBMCAnnals of General Psychiatry1744-859X2025-05-012411610.1186/s12991-025-00572-yAccelerated repetitive transcranial magnetic stimulation in the treatment of depressive disorder resistant to a course of antidepressant medicationMahtab Motamed0Azin Fathi1Arman Hajikarim-Hamedani2Javad Alaghband-rad3Department of Psychiatry, Tehran University of Medical SciencesDepartment of Psychology, Tonekabon Branch, Islamic Azad UniversityFaculty of Medicine, Tehran Medical Sciences, Islamic Azad UniversityDepartment of Psychiatry, Tehran University of Medical SciencesAbstract Aims It is generally known that 30% of Major depressive disorder (MDD) patients do not respond to traditional pharmacological and psychosocial therapy. Transcranial magnetic stimulation (TMS), introduced first in 1985, was a non-invasive neural network research method. Later, repetitive Transcranial Magnetic Stimulation (rTMS) was approved by the FDA to treat treatment-resistant depression (TRD) in 2008. Over the past two decades, rTMS has been extensively developed using various protocols in order to stimulate superficial brain nerve cells non-invasively. We planned to see if high-frequency accelerated left prefrontal rTMS can improve symptoms of treatment resistant depression given its convenience it provides by having patients for fewer treatment sessions. Methods A total of 25 patients were enrolled in the study. Inclusion criteria were age between 18 and 60 and a history of at least one failed treatment with antidepressants. The treatment was conducted over six days scattered over three weeks and each day consisted of three 30-minute sessions (83, 83, and 84 trains for each session). The sessions were separated with 15-minute breaks. rTMS protocol: 120% of the motor threshold and frequency of 10 Hz. Consisting of 2.4 s trains with an intertrain interval of 15-seconds. Result The study included 25 individuals (male: 12/13) with an average age of 36.88 ± 10.61. We compared outcome indicators at baseline and week three after confirming the normality of the data. After three weeks, Hamilton Depression Rating Scale and Clinician Global Impression showed a substantial improvement. There was a remission rate of 24% (6/25) and a response rate of 52% (13/25). Conclusion This work adds to the evidence that rTMS can treat TRD and shows that a more convenient high-frequency accelerated rTMS can improve symptoms in treatment resistant depression. Graphical Abstracthttps://doi.org/10.1186/s12991-025-00572-yDepressionStimulationrTMSAntidepressant medication
spellingShingle Mahtab Motamed
Azin Fathi
Arman Hajikarim-Hamedani
Javad Alaghband-rad
Accelerated repetitive transcranial magnetic stimulation in the treatment of depressive disorder resistant to a course of antidepressant medication
Annals of General Psychiatry
Depression
Stimulation
rTMS
Antidepressant medication
title Accelerated repetitive transcranial magnetic stimulation in the treatment of depressive disorder resistant to a course of antidepressant medication
title_full Accelerated repetitive transcranial magnetic stimulation in the treatment of depressive disorder resistant to a course of antidepressant medication
title_fullStr Accelerated repetitive transcranial magnetic stimulation in the treatment of depressive disorder resistant to a course of antidepressant medication
title_full_unstemmed Accelerated repetitive transcranial magnetic stimulation in the treatment of depressive disorder resistant to a course of antidepressant medication
title_short Accelerated repetitive transcranial magnetic stimulation in the treatment of depressive disorder resistant to a course of antidepressant medication
title_sort accelerated repetitive transcranial magnetic stimulation in the treatment of depressive disorder resistant to a course of antidepressant medication
topic Depression
Stimulation
rTMS
Antidepressant medication
url https://doi.org/10.1186/s12991-025-00572-y
work_keys_str_mv AT mahtabmotamed acceleratedrepetitivetranscranialmagneticstimulationinthetreatmentofdepressivedisorderresistanttoacourseofantidepressantmedication
AT azinfathi acceleratedrepetitivetranscranialmagneticstimulationinthetreatmentofdepressivedisorderresistanttoacourseofantidepressantmedication
AT armanhajikarimhamedani acceleratedrepetitivetranscranialmagneticstimulationinthetreatmentofdepressivedisorderresistanttoacourseofantidepressantmedication
AT javadalaghbandrad acceleratedrepetitivetranscranialmagneticstimulationinthetreatmentofdepressivedisorderresistanttoacourseofantidepressantmedication