Suicidality and relief of depressive symptoms with intermittent theta burst stimulation

Acta Psychiatrica ScandinavicaScott Cunningham MD PhD, et al. | September 30, 2022



Anti-depressants and psychotherapy are effective in one-half to two-thirds of patients with major depressive disorder (MDD).

In contrast, no effective anti-suicide treatment modality exists. The current study showed that accelerated iTBS significantly reduced depressive symptoms and suicidality with minimal side effects and no treatment failures (i.e., suicide attempts).

This was a quadruple blind, sham-controlled, crossover, randomized clinical trial.

Over a 6-week period, patients (18-60 years of age with MDD) received 2 weeks of iTBS (FDA-approved in 2018) and sham stimulation.

A suicide score was determined based on HAMD, MADRS, and BDI-II . Depressive symptoms were assessed using MADRS. C-SSRS was used to determine suicide risk.

A reduction in suicidality was demonstrated in patients (n=81) treated with iTBS, which was correlated with decreased depressive symptoms. The effect of iTBS was greater in patients with previous suicide attempts, patients who were not in a relationship, and patients with increased anxiety and impulsivity.