Impacts of rTMS on Refractory Depression and Comorbid PTSD Symptoms at a Military Treatment Facility
Autor: | Amber Benton, John Coleman, Celia Ona, Michael Yang, Pingyang Liu, Sean Wilkes, Michael B. Lustik |
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Rok vydání: | 2020 |
Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Population behavioral disciplines and activities Hawaii Stress Disorders Post-Traumatic Depressive Disorder Treatment-Resistant 03 medical and health sciences 0302 clinical medicine Refractory mental disorders medicine Humans education Depression (differential diagnoses) Retrospective Studies education.field_of_study business.industry Public Health Environmental and Occupational Health Military Treatment Facility Repeated measures design General Medicine medicine.disease Transcranial Magnetic Stimulation Comorbidity 030227 psychiatry Transcranial magnetic stimulation Military Personnel Treatment Outcome Physical therapy Antidepressant business 030217 neurology & neurosurgery |
Zdroj: | Military Medicine. 185:e1420-e1427 |
ISSN: | 1930-613X 0026-4075 |
Popis: | Introduction Repetitive transcranial magnetic stimulation (rTMS) as a treatment for depression has been studied for over two decades. Repetitive TMS was approved by the Food and Drug Administration in 2008 for the treatment of depression after at least one failed trial of an antidepressant medication of adequate dose and duration. This study evaluated whether rTMS treatments may be associated with measurable improvements in depression and post-traumatic stress disorder (PTSD) symptoms for treated military beneficiaries in Hawaii suffering from depression. It also examined the number of failed medication trials that patients underwent before rTMS treatment. Materials and Methods A retrospective chart review of 77 rTMS patients who received and completed treatment between January 1, 2010 and October 31, 2016 was performed. Under a typical treatment regimen, patients receive rTMS for 6 weeks as well as weekly psychiatric assessments, which included completion of Beck’s Depression Inventory (BDI) and PTSD Checklist (PCL). A mixed model repeated measures analysis was done assuming an autoregressive order one covariance structure to evaluate changes over time. Adjusted analyses were done to assess whether changes over time differed by age, prior diagnosis of PTSD, active duty status, and gender. Results The majority of patients were from the army (74%) and 56% were on active duty. Just over half (53%) were male. Most patients (52%) had completed trials of three or more different antidepressant medications before initiation of treatment with rTMS. The mean number of antidepressant trials was 2.7. BDI and PCL scores were significantly lower at end of treatment on average compared to the pretreatment baseline scores. Mean differences for BDI and PCL were significant with P Conclusions Our research suggests that rTMS treatments may produce a reduction in symptoms of both depression and PTSD in patients with refractory depression and comorbid PTSD. It may be a useful alternative to antidepressants in the treatment of depression in the military population, including those with comorbid PTSD. Broader implementation of this treatment modality may prove beneficial for the purposes of military readiness, given current policies and restrictions on service members who are initiated on antidepressant medications. |
Databáze: | OpenAIRE |
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