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Observational Study
. 2021 Feb;271(1):61-67.
doi: 10.1007/s00406-020-01160-9. Epub 2020 Jul 9.

Concomitant lorazepam use and antidepressive efficacy of repetitive transcranial magnetic stimulation in a naturalistic setting

M Deppe  1 , M Abdelnaim  2 , T Hebel  2 , P M Kreuzer  2 , T B Poeppl  2   3 , B Langguth  2 , M Schecklmann  2
Affiliations
Observational Study

Concomitant lorazepam use and antidepressive efficacy of repetitive transcranial magnetic stimulation in a naturalistic setting

M Deppe et al. Eur Arch Psychiatry Clin Neurosci. 2021 Feb.

Abstract

Background/objectives: Repetitive transcranial magnetic stimulation (rTMS) has been established as an effective therapeutic intervention for the treatment of depression. Preliminary data suggest that the efficacy of rTMS is reduced in patients taking benzodiazepines (BZD). Here, we use real-world data from a large sample to investigate the influence of lorazepam on the effectiveness of rTMS.

Methods: From a retrospective cohort of clinically depressed patients that were treated with rTMS, we compared 176 patients not taking any BZD with 73 patients taking lorazepam with respect to changes in the Hamilton Depression Rating Scale (HRDS).

Results: Both groups improved during rTMS according to HRDS scores, but the amelioration of symptoms was significantly less pronounced in patients taking lorazepam (18% vs. 38% responders in the non-lorazepam group). We could not see any association of intake regimen of lorazepam with response in rTMS.

Conclusion: Our observational study suggests that intake of lorazepam impedes the response to rTMS. The impact of lorazepam and other BZD on rTMS should receive more attention and be further investigated in prospective, hypothesis-based treatment studies to determine causal relationships between medication treatments and outcome. This could lead to specific recommendations for pharmacological treatment for depressed patients undergoing rTMS.

Keywords: Affective disorder; Benzodiazepine; Brain stimulation; Depression; Lorazepam; rTMS.

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Conflict of interest statement

MD, MA, PK, TP, MS and BL declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. TH has had travel expenses paid for by Nexstim Plc.

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