Early relapse treatment (ERT) or “maintenance” transcranial magnetic stimulation (TMS)?

Background: Major depressive disorder (MDD) commonly takes a relapsing form. Transcranial magnetic stimulation (TMS) has be suggested as a means of maintaining remission. Brief courses of TMS at about monthly intervals appear to provide health benefits.

Objective: To examine whether such brief courses of TMS are better conceptualized as maintaining remission, or as the provision of early relapse treatment.

Method: 25 series of treatment (18 different patients) were considered. Pre- and post-treatment 6-item Hamilton Depression Rating Scale (HAMD6) and 7 visual analogue scales (VASs) were collected, along with pretreatment Clinical Global Impression-Severity (CGI-S) and post-treatment CGIImprovement (I).

Results: Pre-treatment HAMD6 and CGI-S indicated that many patients were symptomatic and in early relapse. Post-treatment HAMD6 indicated that many patients had achieved remission, and this was supported by the CGI-I. The VAS scores also improved. Conclusions: Short courses of TMS at about monthly intervals have beneficial results and are better conceptualized as early relapse treatment (ERT).