Impact of repetitive transcranial magnetic stimulation on generalised anxiety disorder in treatment resistant depression

Chris Griffiths, Alex O'Neill-Kerr, Robert de Vai, Ksenija Da Silva

Research output: Contribution to JournalArticle

Abstract

Background: Published evidence indicates the value of repetitive transcranial magnetic stimulation (rTMS) for generalized anxiety disorder in patients with treatment-resistant depression (TRD). As a part of routine clinical service, patients with TRD received right dorsolateral prefrontal cortex (DLPFC) inhibitory rTMS immediately prior to left DLPFC depression treatment delivered according to a US Food and Drug Administration protocol.

Methods: A retrospective investigation of routinely collected data between 2016 and 2018 was undertaken. Measures used were the clinician rated Clinical Global Impressions–Severity (CGI-S) scale and Hamilton Depression Rating scale (HAM-D), and the patient-rated Generalized Anxiety Disorder scale–7 (GAD-7) and Patient Health Questionnaire (PHQ-9). The outcome data of 61 patients with TRD were analyzed. The sample included patients with comorbid psychiatric diagnoses.

Results: Response and remission rates, respectively, were 17.1% and 27.3% on the GAD-7; 20.7% and 12.5% on the HAM-D; 19% and 24% on the PHQ-9; and 20% and 23.5% on the CGI-S. Post-treatment scores significantly improved on the GAD-7, HAM-D, and CGI-S scales, with medium to large effect sizes (.61, .62, and .86 respectively).

Conclusions: Results indicate the potential value of rTMS in treating anxiety in patients who are referred for rTMS for TRD. Well-designed and adequately powered randomized controlled trials are required to determine clinical recommendations.
Original languageEnglish
Pages (from-to)236-241
Number of pages6
JournalAnnals of Clinical Psychiatry
Volume31
Issue number4
Publication statusPublished - 1 Nov 2019

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Treatment-Resistant Depressive Disorder
Transcranial Magnetic Stimulation
Anxiety Disorders
Prefrontal Cortex
Depression
United States Food and Drug Administration
Mental Disorders
Anxiety
Randomized Controlled Trials
Health
Therapeutics

Keywords

  • Repetitive Transcranial Magnetic Stimulation (rTMS)
  • treatment resistant depression
  • service delivery
  • anxiety

Cite this

Griffiths, Chris ; O'Neill-Kerr, Alex ; de Vai, Robert ; Da Silva, Ksenija. / Impact of repetitive transcranial magnetic stimulation on generalised anxiety disorder in treatment resistant depression. In: Annals of Clinical Psychiatry. 2019 ; Vol. 31, No. 4. pp. 236-241.
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Impact of repetitive transcranial magnetic stimulation on generalised anxiety disorder in treatment resistant depression. / Griffiths, Chris; O'Neill-Kerr, Alex; de Vai, Robert; Da Silva, Ksenija.

In: Annals of Clinical Psychiatry, Vol. 31, No. 4, 01.11.2019, p. 236-241.

Research output: Contribution to JournalArticle

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N2 - Background: Published evidence indicates the value of repetitive transcranial magnetic stimulation (rTMS) for generalized anxiety disorder in patients with treatment-resistant depression (TRD). As a part of routine clinical service, patients with TRD received right dorsolateral prefrontal cortex (DLPFC) inhibitory rTMS immediately prior to left DLPFC depression treatment delivered according to a US Food and Drug Administration protocol.Methods: A retrospective investigation of routinely collected data between 2016 and 2018 was undertaken. Measures used were the clinician rated Clinical Global Impressions–Severity (CGI-S) scale and Hamilton Depression Rating scale (HAM-D), and the patient-rated Generalized Anxiety Disorder scale–7 (GAD-7) and Patient Health Questionnaire (PHQ-9). The outcome data of 61 patients with TRD were analyzed. The sample included patients with comorbid psychiatric diagnoses.Results: Response and remission rates, respectively, were 17.1% and 27.3% on the GAD-7; 20.7% and 12.5% on the HAM-D; 19% and 24% on the PHQ-9; and 20% and 23.5% on the CGI-S. Post-treatment scores significantly improved on the GAD-7, HAM-D, and CGI-S scales, with medium to large effect sizes (.61, .62, and .86 respectively).Conclusions: Results indicate the potential value of rTMS in treating anxiety in patients who are referred for rTMS for TRD. Well-designed and adequately powered randomized controlled trials are required to determine clinical recommendations.

AB - Background: Published evidence indicates the value of repetitive transcranial magnetic stimulation (rTMS) for generalized anxiety disorder in patients with treatment-resistant depression (TRD). As a part of routine clinical service, patients with TRD received right dorsolateral prefrontal cortex (DLPFC) inhibitory rTMS immediately prior to left DLPFC depression treatment delivered according to a US Food and Drug Administration protocol.Methods: A retrospective investigation of routinely collected data between 2016 and 2018 was undertaken. Measures used were the clinician rated Clinical Global Impressions–Severity (CGI-S) scale and Hamilton Depression Rating scale (HAM-D), and the patient-rated Generalized Anxiety Disorder scale–7 (GAD-7) and Patient Health Questionnaire (PHQ-9). The outcome data of 61 patients with TRD were analyzed. The sample included patients with comorbid psychiatric diagnoses.Results: Response and remission rates, respectively, were 17.1% and 27.3% on the GAD-7; 20.7% and 12.5% on the HAM-D; 19% and 24% on the PHQ-9; and 20% and 23.5% on the CGI-S. Post-treatment scores significantly improved on the GAD-7, HAM-D, and CGI-S scales, with medium to large effect sizes (.61, .62, and .86 respectively).Conclusions: Results indicate the potential value of rTMS in treating anxiety in patients who are referred for rTMS for TRD. Well-designed and adequately powered randomized controlled trials are required to determine clinical recommendations.

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