Indian Journal of PsychiatryIndian Journal of Psychiatry
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 Table of Contents    
Year : 2020  |  Volume : 62  |  Issue : 7  |  Page : 16
Col. Kirpal Singh Award

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Date of Web Publication14-Jan-2020

How to cite this article:
. Col. Kirpal Singh Award. Indian J Psychiatry 2020;62, Suppl S1:16

How to cite this URL:
. Col. Kirpal Singh Award. Indian J Psychiatry [serial online] 2020 [cited 2021 Jun 20];62, Suppl S1:16. Available from:

   Comparative efficacy of rTMS as an augmentation strategy in treatment resistant depression in military personnel Top

Amit Chail , PS Bhat, Harpreet Singh, Rajiv K Saini, Vinay Singh Chauhan

Department of Psychiatry, Armed Forces Medical College, Pune

Depression causes significant morbidity, disability and mortality, along with socioeconomic losses. Only around one third patients remit with the first treatment with an anti-depressant. Those who don't remit even with second trial of anti-depressant need optimisation, combination or augmentation strategies. Pharmacological strategies sometimes have associated unacceptable adverse effects. Role of non-invasive and relatively safer somatic treatments like rTMS (repetitive Transcranial Magnetic Stimulation) is important. The current study aims to compare efficacy of rTMS with that of standard pharmacological augmentation strategies in unipolar non psychotic treatment resistant depression in military population.


Study Design: Randomized controlled trial

Subjects: Cases of unipolar, non-psychotic treatment resistant depression between ages of 20-60 years

Results: Total 100 patients were randomised into two arms. In the rTMS arm 44 patients and in TAU arm 41 completed the study. After 04 weeks of treatment augmentation, rTMS and TAU groups showed response rates of 52% and 46% respectively. The difference between the two groups in terms of number of responders at the end of 04 weeks is not statistically significant. Factors associated with good response to rTMS were absence of a family history of psychiatric illness, no concomitant psychoactive substance use, being first episode of depression and mild-moderate severity of illness.

Conclusion: rTMS is not inferior to standard pharmacological augmentation therapies.

Keywords: Transcranial magnetic stimulation, treatment resistant depression, neuro-modulation, augmentation.

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Source of Support: None, Conflict of Interest: None

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