Efficacy of repetitive transcranial magnetic stimulation in the treatment of depression with comorbid anxiety disorders

Effect of repetitive transcranial magnetic stimulation on anxiety symptoms in patients with major depression: An analysis from the THREE‐D trial

“…Clarke et al (2019) investigated the efficacy of rTMS in patients with treatment‐resistant MDD and comorbid anxiety disorders. Their study included 248 patients with treatment‐resistant MDD who were treated with rTMS.…”

“…Of these, 172 patients had one or more comorbid anxiety disorders. According to the findings, patients both with and without comorbid anxiety disorders showed improvement in depression ratings after rTMS treatment, with no significant difference in remission rates between groups (Clarke et al, 2019). In a study that looked at the likelihood of response in patients treated with rTMS ( n = 70), responders had less anxiety at baseline in comparison to nonresponders, and higher response rates have been observed in patients receiving rTMS with no comorbid anxiety disorder (54.1%) in comparison to patients with comorbid panic disorder or GAD (35% and 47.3%, respectively; p < .005) (Brakemeier et al, 2007).…”

Transcranial magnetic stimulation and other treatments

“…Malhi et al (2019) raise the question of whether concomitant anxiety is an indicator of poor response to TMS. In a recent 248-patient nonblinded study, Clarke et al (2019) found TMS to be effective in MDD with comorbid anxiety. Malhi et al (2019) report that the patient they described received 30 treatments (funded by the public system), then another 10 treatments (self-funded; for a total of 40) and then a further 10 treatments were recommended -'but the patient refused'.…”

“…Malhi et al (2019) raise the question of whether concomitant anxiety is an indicator of poor response to TMS. In a recent 248-patient non-blinded study, Clarke et al (2019) found TMS to be effective in MDD with comorbid anxiety.…”

We need to know more information about the type of electroconvulsive therapy given before concluding whether or not a trial of electroconvulsive therapy was adequate

“…In respect of the first assertion, there have been some recent articles that challenge this notion. Clarke et al (2019) recently published a study showing that, in patients with major depression and a comorbid anxiety disorder, there was no difference in response or remission rates to rTMS for depressive symptoms, compared to patients without comorbid anxiety. Chen et al’s (2019) study showed that rTMS is effective in alleviating anxiety symptoms as well as depressive symptoms in patients with depression and comorbid anxiety.…”