Bilateral DMPFC-rTMS Leads to Sustained Remission in Geriatric Treatment-Resistant Depression: A Case Report

Sender, David; Nazar, Bruno Palazzo; Baczynski, Tathiana; Paes, Flávia; Fettes, Peter; Downar, Jonathan; Campos, Carlos; Nardi, Antonio Egidio; Machado, Sergio

http://hdl.handle.net/10400.22/14287

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Authors

Nardi, Antonio Egidio

Machado, Sergio

Abstract(s)

Major Depressive Disorder (MDD) is a highly prevalent condition that has been labeled the current leading cause of disability adjusted life years (Ferrari et al. 2013). Approximately 30% of MDD patients are treatment resistant, not achieving remission after two or more antidepressant trials (Baldessarini et al. 2015). In the geriatric population, MDD is associated with both lower rates of remission and increased levels of recurrence (Kiosses & Alexopoulos 2013). Geriatric MDD not only shows an impoverished response to pharmacological approaches, but also presents new treatment challenges associated with clinical limitations such as frequent metabolic issues, comorbidity and poly-medication. Hence, additional therapeutic alternatives such as repetitive transcranial magnetic stimulation (rTMS) might be beneficial in these resistant cases (Downar & Daskalakis 2013).