Effectiveness of an accelerated transcranial magnetic stimulation treatment protocol for patients with treatment-resistant depression and the impact of changing TMS frequency and target location on treatment response

This open label study aims to test the effectiveness of accelerated transcranial magnetic stimulation (aTMS) (4 treatments a day for five days) for treatment-resistant depression and whether changing TMS frequency and coil target location (from 5 Hz left dorsal lateral prefrontal cortex (DLPFC) to 1 Hz right DLPFC) improves treatment response. A total of thirty-eight patients were enrolled and overall treatment response rates increased from 7 % immediately after treatment to 10 % two weeks later. Response rates were observed to be15.8 % immediately after an additional course of treatment for those initial non-remittent and subsequently increased to 18.8 % two weeks later, without any significant difference between the switching and non-switching groups (immediately: 11.1 % vs 20 %, p = 0.596; 2 weeks later: 12.5 % vs 25 %, p = 0.522). In conclusion, there was a possible sign of a delayed onset of treatment response of aTMS on depressive symptoms. Switching the TMS treatment protocol did not yield any outcome improvements.