Repetitive Transcranial Magnetic Stimulation (rTMS) in treatment Resistant Depression: Retrospective Data Analysis from Clinical Practice

Chris Griffiths, Ksenija Maravic da Silva, Rob De Vai , Alex O'Neill-Kerr

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Objective: The aim of this paper is to present the service data results from a clinical repetitive Transcranial Magnetic Stimulation (rTMS) service treating treatment resistant depression (TRD). Methods: The study was a retrospective investigation of routinely collected data on patients receiving rTMS between 2015 and 2018. Measures used were the clinician-rated Clinical Global Impression (CGI) and Hamilton Depression Rating Scale (HAM-D), and patient rated Physical Health Questionnaire (PHQ-9) and Generalised Anxiety Disorder 7 (GAD-7). The outcome data of 144 patients with TRD was analysed. The sample included patients with co-morbid psychiatric diagnosis. Results: Response and remission rates respectively were 34.6% and 20.6% for the HAM-D; 10% and 28.6% for the PHQ-9; 31% and 31.8% for the CGI; and 24.6% and 28.8% for GAD-7. Effect sizes were mostly medium (0.48, 0.27, 0.51, 0.43 respectively). GAD-7 reliable change improvement was 56.1% and PHQ-9 reliable change improvement was 40%. There was a medium positive correlation between anxiety (GAD-7) and depression recovery (HAM-D), r = 0.31, n = 46, p = 0.039, with lower pre-treatment anxiety associated with lower post-treatment HAM-D scores. Conclusions: TRD patients with low pre-treatment anxiety levels respond to treatment better than those with high pre-treatment anxiety. The results show that a clinical rTMS service can have a significant impact on symptoms of depression and anxiety in TRD. The findings support wider availability of rTMS as a treatment option for people with TRD.
Original languageEnglish
Pages (from-to)16-28
Number of pages13
JournalOpen Journal of Depression
Issue number1
Early online date17 Jan 2019
Publication statusPublished - Feb 2019
Externally publishedYes

Bibliographical note

Copyright © 2019 by author(s) and Scientific Research Publishing Inc. This work is licensed under the Creative
Commons Attribution International License (CC BY 4.0).


  • Repetitive Transcranial Magnetic Stimulation (rTMS)
  • Treatment Resistant Depression
  • Service Delivery
  • Anxiety


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