磁刺激
萧条(经济学)
辅助治疗
抗抑郁药
重性抑郁障碍
电休克疗法
5-羟色胺再摄取抑制剂
深部经颅磁刺激
自杀意念
心理学
医学
重性抑郁发作
随机对照试验
精神科
内科学
毒物控制
刺激
精神分裂症(面向对象编程)
伤害预防
心情
焦虑
环境卫生
经济
宏观经济学
作者
Christopher A. Wall,Paul E. Croarkin,Leslie Sim,Mustafa M. Husain,Philip G. Janicak,F. Andrew Kozel,Graham J. Emslie,Sheila M. Dowd,Shirlene Sampson
摘要
Article AbstractObjective: Depression is often a serious and debilitating illness in adolescents. Unfortunately, a significant number of adolescents do not respond to antidepressant medications or psychotherapy. Repetitive transcranial magnetic stimulation (rTMS) is a novel treatment intervention shown to benefit depression in adults. This study considered rTMS as an adjunctive treatment in adolescents with major depressive disorder.Method: This prospective, open, multicenter trial of active adjunctive rTMS was conducted with 8 adolescents with DSM-IV-TR major depressive disorder (MDD) that had not responded sufficiently to 2 adequate antidepressant medication trials. All subjects were maintained on a stable dose of a selective serotonin reuptake inhibitor during the trial. Thirty daily rTMS treatments were given 5 days per week over 6 to 8 weeks. rTMS was applied to the left dorsolateral prefrontal cortex (120% of motor threshold; 10 Hz; 4-second trains; 26-second intertrain interval; 75 trains) for a total of 3,000 stimulations per treatment session.Results: Seven of 8 adolescents completed all 30 treatments. rTMS was well tolerated, and no significant safety issues were identified. Suicidal ideation was present at baseline in 3 of the adolescents, and it improved during treatment. The primary outcome measure was the Children's Depression Rating Scale-Revised (CDRS-R); results improved significantly from baseline (mean ) (65.9 ) to treatment 10 (50.9 ), P < .02. The CDRS-R scores continued to improve through the rTMS treatment series at treatment 20 (40.1 ), P < .01; treatment 30 (32.6 ), P < .0001; and at 6-month follow-up (32.7 ), P < .0001.Conclusions: This prospective open trial suggests that rTMS is a safe, feasible, and potentially effective adjunctive therapy for treatment-resistant MDD in adolescents.Trial Registration: clinicaltrials.gov Identifier: NCT00587639J Clin Psychiatry 2011;72(9):1263-1269© Copyright 2011 Physicians Postgraduate Press, Inc.Submitted: March 11, 2011; accepted April 29, 2011(doi:10.4088/JCP.11m07003).Corresponding author: Christopher A. Wall, MD, Department of Psychiatry and Psychology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (wall.chris@mayo.edu).
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