Dr. Saurabh Kumar
MBBS, M.D. (Psychiatry) 15 years experience overall Psychiatrist , Neuropsychiatrist , Sexologist
Effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) in patients with comorbid panic disorder and major depression
Published In: Australasian Psychiatry
About Australasian Psychiatry: Australasian Psychiatry is a prestigious, peer-reviewed journal that focuses on the intersection of psychiatry and clinical practice in the Australasian region. The journal is committed to disseminating high-quality research that contributes to the understanding and treatment of mental health disorders. With a particular emphasis on innovative therapies and evidence-based psychiatric practices, it serves as a valuable resource for clinicians and researchers aiming to advance psychiatric care globally.
Abstract
This article, co-authored by Dr. Saurabh Kumar and his colleagues, explores the therapeutic potential of high-frequency repetitive transcranial magnetic stimulation (rTMS) in patients diagnosed with both panic disorder and major depression. Published in Australasian Psychiatry, the study provides compelling evidence on the use of high-frequency rTMS applied over the left dorsolateral prefrontal cortex (DLPFC) as a treatment option for this challenging comorbidity. The research is particularly significant given the high prevalence of treatment resistance in patients with comorbid panic disorder and depression.
Key Findings of the Research:
Efficacy of High-Frequency rTMS in Comorbid Conditions: The study involved a retrospective analysis of 13 patients with comorbid panic disorder and major depression who had not responded to at least two previous medications. After 20 sessions of high-frequency rTMS administered over the left DLPFC, the patients showed a 38% reduction in Panic Disorder Severity Scale (PDSS) scores and a 40% reduction in Hamilton Depression Rating Scale (HDRS) scores. These reductions indicate a significant clinical improvement in both panic and depressive symptoms.
Independent Impact on Panic and Depression Symptoms: Interestingly, the changes in PDSS and HDRS scores were not significantly correlated, suggesting that rTMS may have independent therapeutic effects on panic disorder and depression. This finding is important, as it highlights the potential for rTMS to treat both conditions simultaneously, without one condition influencing the severity of the other.
Well-Tolerated with Minimal Side Effects: The patients in the study tolerated rTMS well, with only minor side effects reported, such as headache and localized scalp discomfort in a few cases. No serious adverse effects were observed, further supporting rTMS as a safe and viable option for patients who have exhausted conventional pharmacological treatments.
Significance of Left-DLPFC Stimulation: The study postulates that high-frequency rTMS over the left DLPFC may help restore the balance in frontal cortical activity, which is often asymmetrical in patients with panic disorder and depression. This finding aligns with neuroimaging studies showing that the prefrontal cortex plays a critical role in regulating emotions and controlling subcortical structures involved in panic and anxiety.
Applicability to the General Population:
This study holds significant implications for the broader psychiatric field and the general population. Panic disorder and depression are two of the most prevalent psychiatric disorders globally, and their co-occurrence can severely impact patients' quality of life. The research suggests that rTMS, a non-invasive and relatively low-risk treatment, may offer hope for patients who have not responded to traditional treatments. For the general population, especially those affected by treatment-resistant conditions, the findings highlight an emerging option that could improve mental health outcomes.
Additionally, this study calls attention to the importance of exploring alternative therapies, particularly for individuals who experience debilitating symptoms and are unable to find relief through standard medications. As rTMS becomes more accessible in clinical settings, its potential to treat comorbid conditions such as panic disorder and depression could transform mental health care by offering a new path to recovery for many patients.
In conclusion, "Effect of High-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) in Patients with Comorbid Panic Disorder and Major Depression" offers valuable insights into the application of rTMS for complex psychiatric conditions. By demonstrating the effectiveness of this non-invasive brain stimulation technique, Dr. Saurabh Kumar and his colleagues contribute to the growing body of evidence supporting rTMS as a promising treatment for mental health disorders, paving the way for future research and broader clinical application.
Author Information: Saurabh Kumar, Swarndeep Singh, Arpit Parmar, Rohit Verma, and Nand Kumar. "Effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) in patients with comorbid panic disorder and major depression." Australasian Psychiatry 26, no. 4 (2018): 398-400.
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