Does rTMS hasten the response to escitalopram, sertraline, or venlafaxine in patients with major depressive disorder? A double-blind, randomized, sham-controlled trial

David Rossini, Lorenzo Magri, Adelio Lucca, Silvia Giordani, Enrico Smeraldi, Raffaella Zanardi

Research output: Contribution to journalArticlepeer-review

Abstract

Background/Objective: Repetitive transcranial magnetic stimulation (rTMS) has been mainly studied as adjunctive treatment for drug-resistant patients. We assessed the effectiveness of rTMS started concomitantly with antidepressant medications in non-drug-resistant major depressive disorder patients. We also evaluated if, among the 3 antidepressants administered, one had a better synergy with rTMS. Method: In this 5-week, double-blind, randomized, sham-controlled study, we recruited 99 inpatients suffering from a major depressive episode (DSM-IV criteria). They were randomly assigned to receive venlafaxine, sertraline, or escitalopram in combination with a 2-week period of sham or active 15-Hz rTMS on the left dorsolateral prefrontal cortex. Data were gathered from February 2004 to June 2005. Results: The active rTMS group showed a significantly faster reduction in Hamilton Rating Scale for Depression (HAM-D) scores compared with the sham group (p = .0029). The response and remission rates were significantly greater in the active rTMS group after the stimulation period (p = .002 and p = .003, respectively), but not at the endpoint. We found no significant difference in HAM-D score reduction among the 3 drugs administered, either in the active or in the sham group. Conclusion: These findings support the efficacy of rTMS in hastening the response to antidepressant drugs in patients with major depressive disorder. The effect of rTMS seems to be unaffected by the specific concomitantly administered drug.

Original languageEnglish
Pages (from-to)1569-1575
Number of pages7
JournalJournal of Clinical Psychiatry
Volume66
Issue number12
Publication statusPublished - Dec 2005

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

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