Elín María Árnadóttir, Medical student, Faculty of Medicine, University of Iceland

Nicolas Pétur Blin, Biologist, Brain Stimulation Clinic, Primary Health Care of the Capital Area

 

Jón Gauti Jónsson, Nurse,  Brain Stimulation Clinic, Primary Health Care of the Capital Area

 

Dagur Bjarnason, Physician, Brain Stimulation Clinic, Primary Health Care of the Capital Area

 

Engilbert Sigurðsson, Physician, Faculty of Medicine, University of Iceland & Landspitali University Hospital

Key words: iTBS, rTMS, depression, efficacy, response, remission

Abstract

 

Introduction

Depression is a common, serious and often chronic disorder and one of the leading causes of disability worldwide. The annual prevalence of depression is 5-10%, twice as high among women as men and the lifetime prevalence is at least 20%. Up to a third of depressed individuals meet criteria for treatment-resistant depression, where two antidepressants have been tried for at least 6 weeks each at therapeutic doses. As of January 2022 transcranial magnetic stimulation for adults with treatment-resistant depression that has not responded to other forms of treatment has been available by a service that is part of Primary Health Care of the Capital Area in Iceland.

 

Methods

This a retrospective cohort study where participants completed a course of magnetic transcranial treatment for depression in the years 2022 and 2023. Two validated self-rating measures were used to assess depression. Information on previous treatment approaches for depression was collected from electronic health records.

 

Results

104 individuals completed the treatment in these first two years, 60,6% women. Most had unipolar depression (86,5%), but a small subgroup had bipolar depression (13,5%). The proportion of responders varied according to the measures used, 36,1% and 45,7%, respectively, and the same was true for remission where the proportions were 12,4% and 31,5%, respectively, higher for the longer inventory. The drop-out rate was only 12,5% and no serious adverse events were reported during the treatment.

 

Conclusion

 

The results support that magnetic transcranial stimulation, as provided by this service is effective in treating treatment-resistant or longstanding depression in a real life clinical setting and the low drop-out rate supports that the treatment is generally very well tolerated.