Repetitive transcranial magnetic stimulation in depressed adolescents: experience, knowledge, and attitudes of recipients and their parents.

BACKGROUND: Comprehensive assessment of new treatments in psychiatry should include evaluation of their acceptability to patients, and in the case of children and adolescents, this must extend to acceptability for parents. The views of young patients and their parents in relation to repetitive transcranial magnetic stimulation (rTMS) for adolescent depression have not been previously studied. OBJECTIVE: We sought to (1) describe the experience, knowledge, and attitudes regarding rTMS among young people who had been treated with rTMS for depression as adolescents; (2) report the views of their parents; and (3) compare these to opinions about pharmacotherapy among a group who had been treated with fluoxetine for adolescent depression. METHODS: Eight of 9 subjects who had participated in an open-label rTMS study, 13 of their parents, and an age-matched group of 8 subjects who had been treated with fluoxetine for depression as adolescents were assessed using detailed questionnaires. RESULTS: Repetitive TMS recipients and their parents found rTMS largely acceptable in terms of adverse effects and treatment experience, but most considered it ineffective. In contrast, most patients who had been treated with fluoxetine viewed their treatment as effective. CONCLUSIONS: Transcranial magnetic stimulation is relatively well tolerated by depressed adolescents, but it is also perceived as mostly unhelpful by them and their parents. This is at odds with emerging studies suggesting that rTMS can be an effective and safe treatment in this age group, indicating that further research is required to confirm our findings and understand reasons for any disparity.

Repetitive transcranial magnetic stimulation in the treatment of depression in adolescents: an open-label study.

OBJECTIVE: This open-label pilot study examined repetitive transcranial magnetic stimulation as a possible treatment of adolescent resistant depression. METHOD: Nine adolescents (aged 16-18 years) with severe resistant depression (determined by SCID) were recruited, and their depression, suicidality, and cognitive functions were evaluated before, during, and after a course of twenty 10-Hz, 2-second trains (intertrain intervals of 58 seconds) given over 20 min/d over 14 working days. RESULTS: Lower levels of depression with progression in therapy were recorded by both the Beck Depression Inventory and Child Depression Rating Scale measures (F1.7,14.01 = 4.52, P < 0.05; F4,32 = 6.645, P < 0.01, respectively). Three patients reached the primary outcome measure of less than 30% reduction in their Child Depression Rating Scale. The effect on suicidality was not significant. Side effects were considered mild. CONCLUSIONS: Repetitive transcranial magnetic stimulation might be a possible therapy for adolescent depression. Our preliminary findings warrant double-blind, controlled studies.