Abstract

BROCKER, Erine; VAN DEN HEUVEL, Leigh  and  SEEDAT, Soraya. Accelerated theta-burst repetitive transcranial magnetic stimulation for depression in South Africa. S. Afr. j. psyc. [online]. 2019, vol.25, n.1, pp.1-4. ISSN 2078-6786.  http://dx.doi.org/10.4102/sajpsychiatry.v25i0.1346.

This case series documents local experience using accelerated theta-burst repetitive transcranial magnetic stimulation (rTMS) as a supplementary treatment for depression in both major depressive disorder (MDD) and bipolar disorder (BD). Nine consenting patients (MDD = 7; BD = 2) each received 20 accelerated theta-burst sessions over 8 days. Improvement was monitored using the Centre for Epidemiological Studies Depression (CES-D) Scale and the Clinical Global Impression (CGI) Scale at baseline, at day 5 and at day 8 of rTMS treatment. We performed a Wilcoxon matched-pairs signed-rank test to determine whether there was a difference in scores from baseline to post-treatment. The CES-D scores decreased significantly from baseline to post-treatment (Z = −2.547, p = 0.011) with five patients experiencing at least a 50% symptom reduction on the CES-D. CGI severity scores also decreased significantly between baseline and post-treatment (Z = −2.547, p = 0.011). The most commonly reported adverse effect was mild headaches, lasting a few hours during and after rTMS treatment. The findings suggest that the accelerated theta-burst rTMS protocol for depression is well tolerated with most patients also experiencing symptomatic improvement by day 8.

Keywords : theta-burst stimulation; TBS; Depression; accelerated repetitive transcranial magnetic stimulation; bipolar depression; BP; treatment resistant depression.

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