Repetitive transcranial magnetic stimulation for treatment‐resistant depression in an elderly patient with an unruptured intracranial aneurysm: a case report

2021 ◽  
Author(s):  
Yuki Matsuda ◽  
Rema Terada ◽  
Kodai Yamada ◽  
Ryuichi Yamazaki ◽  
Akihiko Nunomura ◽  
...  
Keyword(s):  
Elderly Patient ◽  
Case Report ◽  
Transcranial Magnetic Stimulation ◽  
Intracranial Aneurysm ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Unruptured Intracranial Aneurysm ◽  
Resistant Depression

scholarly journals Long-Term Efficacy of Combination Therapy of Transcranial Magnetic Stimulation with Ketamine for Patients with Treatment-Resistant Depression

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 171-171
Author(s):  
Steve Best ◽  
Dan G. Pavel ◽  
Natalie Haustrup
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Nmda Receptor Antagonist ◽  
Primary Diagnosis ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Invasive Treatment ◽  
Novel Approach ◽  
Resistant Depression

AbstractBackgroundRepetitive transcranial magnetic stimulation (rTMS) is a safe, effective and non-invasive treatment for many psychiatric illnesses, including treatment-resistant depression (TRD). Ketamine, an NMDA receptor antagonist, is also an effective antidepressant. This retrospective review examined the clinical benefits of combining these two established treatments for patients suffering from TRD in a novel approach coined combination TMS with ketamine (CTK).MethodsA group of 28 adult patients with a primary diagnosis of unipolar (n=18) or bipolar (n=10) depression received three CTK treatments a week at a private neuropsychiatric practice. Patients were given a concurrent treatment of rTMS (1Hz; 40 minutes; 130% of motor threshold) with bio-marker-determined IV ketamine infusions (0.2–4.7 mg/kg; 30 minutes). The TMS coil was positioned on the mid-prefrontal area. Frequency of treatment was dependent on patient responsiveness (10–30 sessions), which was measured as symptom reduction on the Clinical Global Impression (CGI) scale. CGI data was evaluated pre-treatment, post-treatment and at two-year follow-up.ResultsMean reduction in CGI severity for the patient group following CTK was 4.46 ± 0.54 at a 99% confidence interval and was deemed statistically significant using a paired t-test (a=0.01, t=22.81, p < 0.0001). This significant reduction in CGI severity was sustained for at least 2 years following treatment completion.ConclusionsDespite years of unsuccessful treatments, all 28 patients in this trial obtained substantial and enduring reductions in their depressive symptoms following CTK therapy. Further research into method optimization and randomized controlled trials are warranted.

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