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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EFor patients with treatment-resistant depression, long-term maintenance therapy with 1 weekly session of repetitive transcranial magnetic stimulation (rTMS) shows promise in preventing relapse in patients who respond to acute rTMS treatment. This article presents preliminary results on a 1-year, double-blind, randomized controlled trial evaluating the efficacy of rTMS as maintenance therapy for patients with treatment-resistant depression.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EMood Disorders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EPsychiatry Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EPsychiatry\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EMood Disorders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EPsychiatry Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EFor patients with treatment-resistant depression, long-term maintenance therapy with 1 weekly session of repetitive transcranial magnetic stimulation (rTMS) shows promise in preventing relapse in patients who respond to acute rTMS treatment. Ren\u00e9 Benadhira, MD, Unit\u00e9 de Recherche Clinique, Paris, France, presented preliminary results on a 1-year, double-blind, randomized controlled trial evaluating the efficacy of rTMS as maintenance therapy for patients with treatment-resistant depression.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EThe study consisted of 2 phases. In Phase 1, all patients received acute treatment with active high-frequency stimulation with rTMS during 4 blocks of 5 consecutive working days in an open-label phase of the trial. In Phase 2, patients who responded to acute treatment were randomized to maintenance therapy with sham or rTMS for 11 months. During Phase 2, the rhythm of rTMS sessions was gradually reduced to 3 sessions per week for 2 weeks, 2 sessions per week for the following 2 weeks, 1 session per week for the third month (M3) and fourth (M4), and then 1 session every 2 weeks for the last 8 months (M5 to M12). The primary outcome was improvement in symptoms of depression based on the 17-item Hamilton Depression Rating Scale (HAM-D). Responders were defined as those who achieved \u0026gt;49% reduction in HAM-D score from baseline.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EProf. Benadhira reported on the intermediate analysis of 69 patients. Most patients were female (n=43) and had unipolar depression (79.7%). The mean age was \u223c51 years; the mean duration of education was \u223c11 years; and the mean duration of illness was tilde;8 years. At baseline, the mean HAM-D score was 22.59. Results of the Phase 1 part of the trial showed that 33 (48%) patients responded to acute treatment with rTMS, 15 (22%) achieved partial response, and 2 (2.9%) achieved remission (ie, defined as HAM-D \u0026lt;8). Of the 33 responders, 14 agreed to participate in Phase 2 of the trial and were randomized to active rTMS (n=9) or sham treatment (n=5). Results of Phase 2 showed significant difference in HAM-D score between active rTMS and sham at 4, 5, and 6 months (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E). Additional assessments of efficacy also showed significant differences between active rTMS and sham.\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/15974\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/15974\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/15974\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-5\u0022 class=\u0022first-child\u0022\u003ESignificant Difference in HAM-D Score Between Active rTMS and Sham Treatment, p Values\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-10\u0022\u003EOverall, the Phase 2 part of the study showed that all patients treated with rTMS maintained a response to treatment during the 4 weeks of further treatment. At 4, 5, and 6 months, patients on maintenance rTMS had significant improvement in depressive symptoms when compared with patients in the sham treatment group, as shown by the HAM-D scores. This significant difference in change in HAM-D score disappeared starting at Month 7, which, according to Prof. Benadhira, was due to the insufficient number of treatment sessions (ie, 1 session every 2 weeks).\u003C\/p\u003E\u003Cp id=\u0022p-11\u0022\u003EThese results suggest that maintenance therapy with 1 session of rTMS per week may be able to prevent relapses in these patients, said Prof. Benadhira, who also emphasized the need for a larger study to confirm the result.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/8\/19.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzp8hd\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzp8hd\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}