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Accelerated Intermittent Theta Burst Stimulation for Suicide Risk in Therapy-Resistant Depressed Patients: A Randomized, Sham-Controlled Trial

View Article: PubMed Central - PubMed

ABSTRACT

Objectives:: We aimed to examine the effects and safety of accelerated intermittent Theta Burst Stimulation (iTBS) on suicide risk in a group of treatment-resistant unipolar depressed patients, using an extensive suicide assessment scale.

Methods:: In 50 therapy-resistant, antidepressant-free depressed patients, an intensive protocol of accelerated iTBS was applied over the left dorsolateral prefrontal cortex (DLPFC) in a randomized, sham-controlled crossover design. Patients received 20 iTBS sessions over 4 days. Suicide risk was assessed using the Beck Scale of Suicide ideation (BSI).

Results:: The iTBS protocol was safe and well tolerated. We observed a significant decrease of the BSI score over time, unrelated to active or sham stimulation and unrelated to depression-response. No worsening of suicidal ideation was observed. The effects of accelerated iTBS on mood and depression severity are reported in Duprat et al. (2016). The decrease in suicide risk lasted up to 1 month after baseline, even in depression non-responders.

Conclusions:: This accelerated iTBS protocol was safe. The observed significant decrease in suicide risk was unrelated to active or sham stimulation and unrelated to depression response. Further sham-controlled research in suicidal depressed patients is necessary. (Clinicaltrials.gov identifier: NCT01832805).

No MeSH data available.


Related in: MedlinePlus

Beck Scale of Suicide ideation (BSI) scores before and after active and sham treatment. Graphical representation of the BSI mean scores with Time (baseline (T1), after 1 week of stimulation (T2), after finishing the treatment protocol (T3) and 2 weeks later (T4)) as within-subjects variable, and Order (sham > active vs. active > sham) as between-subjects factor. *Indicates significant difference.
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Figure 2: Beck Scale of Suicide ideation (BSI) scores before and after active and sham treatment. Graphical representation of the BSI mean scores with Time (baseline (T1), after 1 week of stimulation (T2), after finishing the treatment protocol (T3) and 2 weeks later (T4)) as within-subjects variable, and Order (sham > active vs. active > sham) as between-subjects factor. *Indicates significant difference.

Mentions: Analyses showed a significant decrease of BSI scores over time (p < 0.01) between T1 and T2. There was no significant effect of the order of treatment (sham-iTBS vs. iTBS-sham; p = 0.66) and no significant interaction effect (p = 0.45; see Figure 2).


Accelerated Intermittent Theta Burst Stimulation for Suicide Risk in Therapy-Resistant Depressed Patients: A Randomized, Sham-Controlled Trial
Beck Scale of Suicide ideation (BSI) scores before and after active and sham treatment. Graphical representation of the BSI mean scores with Time (baseline (T1), after 1 week of stimulation (T2), after finishing the treatment protocol (T3) and 2 weeks later (T4)) as within-subjects variable, and Order (sham > active vs. active > sham) as between-subjects factor. *Indicates significant difference.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5037167&req=5

Figure 2: Beck Scale of Suicide ideation (BSI) scores before and after active and sham treatment. Graphical representation of the BSI mean scores with Time (baseline (T1), after 1 week of stimulation (T2), after finishing the treatment protocol (T3) and 2 weeks later (T4)) as within-subjects variable, and Order (sham > active vs. active > sham) as between-subjects factor. *Indicates significant difference.
Mentions: Analyses showed a significant decrease of BSI scores over time (p < 0.01) between T1 and T2. There was no significant effect of the order of treatment (sham-iTBS vs. iTBS-sham; p = 0.66) and no significant interaction effect (p = 0.45; see Figure 2).

View Article: PubMed Central - PubMed

ABSTRACT

Objectives:: We aimed to examine the effects and safety of accelerated intermittent Theta Burst Stimulation (iTBS) on suicide risk in a group of treatment-resistant unipolar depressed patients, using an extensive suicide assessment scale.

Methods:: In 50 therapy-resistant, antidepressant-free depressed patients, an intensive protocol of accelerated iTBS was applied over the left dorsolateral prefrontal cortex (DLPFC) in a randomized, sham-controlled crossover design. Patients received 20 iTBS sessions over 4 days. Suicide risk was assessed using the Beck Scale of Suicide ideation (BSI).

Results:: The iTBS protocol was safe and well tolerated. We observed a significant decrease of the BSI score over time, unrelated to active or sham stimulation and unrelated to depression-response. No worsening of suicidal ideation was observed. The effects of accelerated iTBS on mood and depression severity are reported in Duprat et al. (2016). The decrease in suicide risk lasted up to 1 month after baseline, even in depression non-responders.

Conclusions:: This accelerated iTBS protocol was safe. The observed significant decrease in suicide risk was unrelated to active or sham stimulation and unrelated to depression response. Further sham-controlled research in suicidal depressed patients is necessary. (Clinicaltrials.gov identifier: NCT01832805).

No MeSH data available.


Related in: MedlinePlus