Transcranial magnetic stimulation (TMS) outcomes for depression show high relapse rates and lack durability beyond 6 months.
"and the outcomes, although now they're modifying a little bit, but the outcomes they don't they're not durable really after 6 months. It's a high relapse rate, you know" (said at 0:37:20)
The speaker claims that transcranial magnetic stimulation (TMS) outcomes for depression are not durable past 6 months and feature a high relapse rate. Systematic reviews, meta-analyses, and prospective follow-up studies demonstrate that acute TMS treatment response is durable beyond 6 months, though durability varies based on maintenance regimens and patient characteristics. A meta-analysis by Senova et al. (2019) found that 52.9% of responders sustained response at 6 months and 46.3% sustained response at 12 months after induction. In naturalistic studies with pragmatic maintenance protocols or retreatment access (Dunner et al., 2014; Janicak et al., 2010), 62.5% of responders maintained response through 12 months, and relapse rates under protocol-specified continuation monotherapy over 6 months were as low as 10-13%. Because TMS benefits persist for a significant proportion of patients past 6 months and relapse rates are moderate rather than uniformly high (especially when combined with continuation strategies), claiming a general lack of durability past 6 months overstates the clinical evidence.
- contradicts: Durability of clinical benefit with transcranial magnetic stimulation (TMS) in the treatme… (Brain stimulation 2010)
"Ten of 99 (10%; Kaplan-Meier survival estimate = 12.9%) patients relapsed... These initial data suggest that the therapeutic effects of TMS are durable and that TMS may be successfully used as an intermittent rescue strategy to preclude impending relapse." (abstract, results/conclusions)
pubmedfull study (doi) - contradicts: A multisite, naturalistic, observational study of transcranial magnetic stimulation for pa… (The Journal of clinical psychiatry 2014)
"Among 120 patients who met IDS-SR response or remission criteria at the end of acute treatment, 75 (62.5%) continued to meet response criteria throughout long-term follow-up... TMS demonstrates a statistically and clinically meaningful durability of acute benefit over 12 months of follow-up." (abstract, results/conclusions)
pubmedfull study (doi) - contradicts: Durability of antidepressant response to repetitive transcranial magnetic stimulation: Sys… (Brain stimulation 2019)
"Among initial responders, 66.5% sustained response at m3 (95% CI = 57.1-74.8%, I 2 = 27.6%), 52.9% at m6 (95% CI = 40.3-65%, I 2 = 0%), and 46.3% at m12 (95% CI = 32.6-60.7%, I 2 = 0%), in the absence of any major bias... rTMS is a durable treatment for depression, with sustained responder rates of 50% up to 1 year after a successful induction course of treatment." (abstract, results/conclusions, passage verified)
pubmedfull study (doi)