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Adding repetitive transcranial magnetic stimulation to antidepressants does not improve response in people with depression

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Dr U Herwig

Correspondence to: Dr U Herwig, Psychiatric University Hospital, University of Zürich, Lenggstrasse 31, CH-8032 Zürich, Switzerland; uwe.hrwig@puk.zh.ch

QUESTION

Question:

Does repetitive transcranial magnetic stimulation (rTMS) alleviate depression in people receiving antidepressants?

Patients:

127 adults experiencing a moderate to severe depressive episode (DSM-IV and ICD-10 criteria, including bipolar depression), with a score of ⩾18 on at least two out of three depression rating scales (Beck Depression Inventory, 21 item Hamilton Rating Scale for Depression, Montgomery-Åsberg Depression Rating Scale). Exclusions: psychiatric disorders other than depression, severe medical disorders, neurological disorders, prior epileptic seizures, heart pacemaker, brain lesions or neurosurgery, involuntary hospitalisation.

Setting:

Seven university clinics in Germany and Austria; time period not stated.

Intervention:

Real rTMS (10 Hz stimulation, 110% of motor threshold, 2000 stimuli a day to the left dorsolateral prefrontal cortex) or sham rTMS (same stimulation protocol, but with electrodes placed so that only a weak electromagnetic field reached the …

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