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Psych Congress  

Repetitive Transcranial Magnetic Stimulation for Non-psychotic Major Depressive Disorder - 'Real World' Outcomes for an Entire Metropolitan Area from Introduction of rTMS in 2012 through May 2016, the San Antonio Experience

Ted Williams, MD
Juan Campos, MD
Kelly Cowan, MD
Melissa De Jesus Quinn, MD
Grace Salinas, MD
Andrew Martin, MD

This poster was presented at the 29th Annual U.S. Psychiatric & Mental Health Congress, held October 21-24, 2016, in San Antonio, Texas.

Treatment options are limited for patients with major depressive disorder that has not responded to 3-4 trials of antidepressant medications or psychotherapy, and repetitive transcranial magnetic stimulation is a promising option. Randomized, controlled trials prior to FDA approval are routinely conducted to evaluate the efficacy and tolerability of a new treatment, but rarely is it possible to gather almost all of the real-world data of that treatment after it has been introduced to an entire metropolitan area. That is the purpose of this study, to retrospectively examine the outcomes of virtually all of the patients diagnosed with non-psychotic major depressive disorder who were treated with repetitive transcranial magnetic stimulation in San Antonio since rTMS was first introduced in 2012 through May 2016. Data was pooled from four practices in San Antonio on patients treated with rTMS. 176 patients each received approximately 36 treatments utilizing 10 Hz and other protocols. Self-report scales (PHQ-9) measured illness severity prior to and upon completion of treatment. Results showed response rates of 70%, and remission rates of 48%. Secondary measures were pooled response and remission rates as determined by MADRAS scores, or BDI-I scores, with pooled response rates of 85% and remission rates of 59%. The treatments were well tolerated and only one patient dropped out due to problems with tolerability. There were no seizures or other significant safety issues. This 'real-world' data should encourage increased utilization of rTMS as a treatment option for major depressive disorder not adequately responding to medication or therapy.

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