61% of unmedicated treatment resistant depression patients who did not respond to acute TMS treatment responded after four weeks of twice weekly deep TMS in the Brainsway pivotal trial

Background:

An acute course of dTMS typically involves treatments delivered 5 days a week, for 4 weeks.Should more treatments be given if the patient has not responded? Data are needed to inform decisions about the best next steps for acute non-responders.

Objective:

To characterize response among acute-phase non-responders in a randomized controlled trialof deep repetitive transcranial magnetic stimulation (dTMS) monotherapy for medication-resistantdepression.

Methods:

Summary statistics and Kaplan-Meier curves were used to characterize outcomes of 33medication-free BrainswayTMdTMS non-responders to double blind but active treatment at the end of 4 weeks (20 sessions), who then continued double blind but active twice weekly treatment for up to 12 additional weeks.

Results:

24 participants (72.7%) achieved responder status during at least one rating with dTMScontinuation -20 (60.6%) within four weeks, with 13 (39.4%) consistently meeting response criteria for the duration of the study. 20 (63.6%) achieved remission status at some point during treatment continuation.

Conclusions:

A significant proportion of acute course non-responders to dTMS treatment eventuallyrespond with continued treatment. Continuing TMS treatment beyond the acute course for non-responders may result in eventual response in over half of these individuals.

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