Repetitive transcranial magnetic stimulation in the treatment of major depressive disorder: Preliminary results from the United Arab Emirates

• Main Authors: Ola Mohamed Ali, Seada Kassie, Veena Luthra, Adel Karrani, Kirsten Orr, Taoufik Alsaadi, Abdulnaser Arida
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: Hamdan Medical Journal
• Subjects: dorsolateral prefrontal cortex; major depressive disorder; middle east and north africa; neuromodulation therapy; repetitive transcranial magnetic stimulation; united arab emirates
• Online Access: http://www.hamdanjournal.org/article.asp?issn=2227-2437;year=2020;volume=13;issue=1;spage=46;epage=51;aulast=
• ISSN: 2227-2437; 2227-247X

Background: Despite evidence for its efficacy, the use of repetitive transcranial magnetic stimulation (rTMS) to treat major depressive disorder (MDD) remains limited in the Middle East and North Africa. The following study evaluated the efficacy of this therapy on patients diagnosed with MDD attending the Outpatient Clinic at the American Center for Psychiatry and Neurology in Abu Dhabi, United Arab Emirates. Methods: Thirty-three patients with treatment-resistant MDD were treated with rTMS according to the Food and Drug Administration (FDA)-approved protocol. The patients received five treatment sessions per week over a period of 4–6 weeks, and they completed the Patient Health Questionnaire (PHQ-9) before and after the treatment course. Results: We observed a 58% response rate to treatment, with a 30% remission rate of depressive symptoms, consistent with previous studies. Limitations: Our results do not reflect long-term efficacy of rTMS, as post-therapy scores were obtained immediately after treatment. Although significant, the reduction in PHQ-9 scores cannot be generalised due to the relatively small sample size. Future studies could look into specific characteristics of patients for better profiling of rTMS candidates. Conclusion: An FDA-approved protocol involving five weekly sessions of rTMS over the dorsolateral prefrontal cortex was effective in treating MDD. Our secondary finding of lower acceptability rate among patients may indicate the need for shortened treatment duration and comprehensive insurance plans providing coverage for rTMS therapy.