Repetitive Transcranial Magnetic Stimulation (rTMS) in Depression
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Purpose
This study will report on the outcomes of rTMS administered 3 times per week, compared with the standard protocol of 5 times per week. Participants will be randomly assigned to frequency condition and depressive symptomatology will be measured weekly using a range of clinician and self-rated questionnaires. Participants will remain in the study for at least 4 weeks, with the option of continuing for a further 2 weeks as judged by the study psychiatrist. It is hypothesised that rTMS administered three times per week will be equally as effective as rTMS administered five times per week in reducing depressive symptomatology.
| Condition | Intervention | Phase |
|---|---|---|
|
Depression |
Device: rTMS 5 x weekly Device: rTMS 3 times weekly |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | A Randomised Study of rTMS in Depression |
- Depression Rating Scales [ Time Frame: weekly ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 40 |
| Study Start Date: | May 2009 |
| Estimated Study Completion Date: | August 2011 |
| Estimated Primary Completion Date: | August 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: five times weekly
Patients will receive rTMS on each weekday for 4 weeks (5 x weekly)
|
Device: rTMS 5 x weekly
Patients will receive rTMS five times weekly for 4 weeks
|
|
Experimental: three times weekly
Patients will receive rTMS three times weekly for four weeks
|
Device: rTMS 3 times weekly
Patients will receive rTMS 3 times weekly for 4 weeks
|
Detailed Description:
Numerous studies have demonstrated the efficacy of active rTMS over sham rTMS for depression; however, few have systematically studied the optimal frequency of treatment sessions to achieve this efficacy. To date, the majority of studies have administered rTMS every weekday, although this approach has not been widely contested. In addition, most studies have only assessed the effectiveness of rTMS over a two week period, which has resulted in some improvement in depressive symptomatology; however, a longer treatment course would likely result in greater improvement. In this study depressed patients will be randomly assigned to receive rTMS either 3 or 5 times per week, for a period of 4-6 weeks. A range of rating scales will be used to assess the improvement of depressive symptomatology within and between the two frequency groups, to ultimately determine whether TMS is needed 5 times per week to achieve adequate anti-depressant effects or whether 3 times per week is sufficient in achieving a similar level of efficacy for patients.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Aged >/= 18
- DSM-IV diagnosis of Major Depressive Episode (bipolar or MDD)
- MADRS score >/= 20
- Able to give informed consent
- Psychoactive medication dosages have been stable for a period of 4 weeks prior to entry in the study
Exclusion Criteria:
- Co-morbid alcohol or drug abuse or dependence (last 3 months), current eating disorder, mental retardation, schizophrenia, rapid cycling bipolar
- A history of mood 'switching' in response to other treatments, which cannot be contained by concurrent treatment, e.g., mood stabiliser
- Pregnancy
- Significant neurological disorder that increases seizure risk
- Metal objects in the head, pacemakers, or a history of epilepsy
- Patients who have failed to respond to a course of ECT in their current episode of depression
- A high risk of suicide
Contacts and Locations| Australia, New South Wales | |
| Northside Clinic | |
| Greenwich, New South Wales, Australia, 2065 | |
| Principal Investigator: | Colleen Loo, MBBS, FRANZCP, MD | University of NSW |
More Information
No publications provided
| Responsible Party: | Associate Professor Colleen Loo, University of NSW |
| ClinicalTrials.gov Identifier: | NCT00920322 History of Changes |
| Other Study ID Numbers: | NSG HREC 153, UNSW HREC 9074 |
| Study First Received: | June 11, 2009 |
| Last Updated: | July 19, 2011 |
| Health Authority: | Australia: Human Research Ethics Committee |
Keywords provided by Northside Clinic, Australia:
|
Depression Transcranial Magnetic Stimulation |
Additional relevant MeSH terms:
|
Depression Depressive Disorder Behavioral Symptoms Mood Disorders Mental Disorders |
ClinicalTrials.gov processed this record on May 16, 2013