Transcranial magnetic stimulation in adolescent depression

OBJECTIVE: There are few safe and effective biological treatments for major depression in adolescents. We aimed to report the use of repetitive transcranial magnetic stimulation (rTMS) as a treatment for adolescents with this condition. METHODS: The first two subjects in a double-blind, sham-controlled trial of rTMS that is evaluating the efficacy and safety of rTMS in depressed adolescents are described. Clinical response was assessed at baseline and at the end of each week. The following scales were used: Montgomery-Asberg Depression Rating Scale, Clinical Global Impression-Severity Scale, Beck Depression Inventory and Centre for Epidemiological Studies - Depression - Child Scale. A battery of cognitive tests was also used at several intervals to measure potential change in neuropsychological functioning. RESULTS: Random allocation of both subjects was to active treatment. Both subjects improved to a clinically significant degree with rTMS treatment and reported no adverse effects. Neuropsychological testing did not demonstrate any deterioration in the domains of functioning tested. CONCLUSIONS: Repetitive transcranial magnetic stimulation shows early promise as a treatment for major depression in adolescents. Well-designed, sham-controlled studies are now indicated to test the efficacy and safety of rTMS in these patients.