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Acceptability, safety and tolerability of antidepressant repetitive transcranial magnetic stimulation for adolescents : a mixed-methods investigation
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Wallman, Emily Jean, Segrave, Rebecca Anne, Gordon, Michael Solomon, Fraser, Maxwell James Oliver Barnett, Pavlou, Chris and Melvin, Glenn A. (2022) Acceptability, safety and tolerability of antidepressant repetitive transcranial magnetic stimulation for adolescents : a mixed-methods investigation. Journal of Affective Disorders, 310 . pp. 43-51. doi:10.1016/j.jad.2022.04.057 ISSN 0165-0327.
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Official URL: http://dx.doi.org/10.1016/j.jad.2022.04.057
Abstract
Objective
Major depressive disorder (MDD) is relatively common in adolescence, with far-reaching impacts. Current treatments frequently fail to alleviate depression severity for a substantial portion of adolescents. Repetitive transcranial magnetic stimulation (rTMS) may assist with this unmet clinical need. However, little is known about adverse events (AEs) experienced by adolescents receiving rTMS, subjective treatment experiences of adolescents and their parents, or treatment acceptability.
Methods
Fourteen adolescents (16.5 years ± 1.2; 71.4% female) with MDD received 20 sessions of either high-frequency (10 Hz; n = 7) left dorsolateral prefrontal cortex (DLPFC) or low-frequency (1 Hz; n = 7) right DLPFC rTMS. AEs were monitored at baseline and at weekly intervals via New York State Psychiatric Institute Side Effects Form for Children and Adolescents. Eight adolescents and nine parents participated in interviews regarding subjective treatment experience, analysed via content analysis.
Results
Drowsiness and lethargy were common AEs, reported by 92.3% of participants in week one. Number of AEs decreased throughout treatment course (after 5 treatments: M = 11.23, SD = 5.00; after 20 treatments: M = 8.92, SD = 5.95). Thirty-five AEs emerged during treatment, most commonly transient dizziness. Frequency, severity, and number of AEs reported were equivalent between treatment groups. Treatment adherence and satisfaction were high. Qualitative findings identified three themes relating to rTMS experience: Preparation and connection; Physical experience of treatment; and Perceived role of treatment.
Limitations
Sample size was small, therefore findings are preliminary.
Conclusions
rTMS was an acceptable treatment for adolescent MDD, from both adolescents' and parents' perspectives, and was safe and well-tolerated, as AE frequency and type did not differ from rTMS treatment courses in adults.
Item Type: | Journal Article | ||||||||
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Divisions: | Faculty of Social Sciences > Centre for Educational Development, Appraisal and Research (CEDAR) | ||||||||
Journal or Publication Title: | Journal of Affective Disorders | ||||||||
Publisher: | Elsevier Science BV | ||||||||
ISSN: | 0165-0327 | ||||||||
Official Date: | 2022 | ||||||||
Dates: |
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Volume: | 310 | ||||||||
Page Range: | pp. 43-51 | ||||||||
DOI: | 10.1016/j.jad.2022.04.057 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Open Access (Creative Commons) |
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