A naturalistic study of the efficacy and acceptability of rTMS in treating major depressive disorder in Australian youth

Abstract Objective Repetitive transcranial magnetic stimulation (rTMS) is an effective, evidence-based treatment for major depressive disorder (MDD) and is publicly funded in Australia. However, there is no published data to date concerning its use in private TMS service provider clinics in Australia. There is further limited data as to its efficacy and safety in treating MDD in youth populations. Methods This retrospective study examined routinely collected data of 46 outpatients aged 17 to 25 years old, who received rTMS treatment for MDD in a private TMS clinic. Primary outcomes measures were the Montgomery-Asberg Depression Rating Scale (MADRS) and the depression subscale of the 21-item Depression, Anxiety and Stress Scale (DASS-21). Secondary measures included the anxiety and stress sub-scales of the DASS-21, a measure of Quality of Life (QoL) Enjoyment and Satisfaction Questionnaire, and the Cognitive Failures Questionnaire (CFQ). Results A 4–7-week course of rTMS significantly reduce symptoms of self-reported depression (42.5% response) and clinician-assessed depression (40.7% response). Both anxiety and stress significantly reduced across the course of rTMS treatment and significant improvements to QoL and self-reported cognition were observed. Reported side effects following rTMS in youth included a mild headache and fatigue. Conclusions The findings of this naturalistic study suggest that an acute course of rTMS provided in private clinical settings is safe and effective – resulting in similar response rates in youth patients as reported in adult patients. In real world practice, rTMS proves to be a well-tolerated and highly effective intervention for MDD in youth, across diverse clinical settings. Implications and Contribution The findings of this naturalistic study suggest that in real world practice, rTMS proves to be a well-tolerated and highly effective intervention for treating depression and anxiety in youth (17–25-year-olds), with additional benefits to cognitive symptoms of depression and overall well-being.