Nonpharmacologic Interventions for Treatment-Resistant Depression in Adults
Comparative clinical research on nonpharmacologic treatments for TRD is in its infancy. Comparative outcomes for both ECT and rTMS are similar, with no synergistic effect from combining these therapies. Regarding efficacy, indirect evidence suggests that rTMS is effective in response and remission over sham treatment. The effectiveness of ECT was not addressed in the review. No benefit was seen for VNS over sham treatment. Evidence regarding adverse effects is limited.
- Gaynes BN, Lux L, Lloyd S, et al. Nonpharmacologic Interventions for Treatment-Resistant Depression in Adults. Comparative Effectiveness Review No. 33 (Prepared by RTI International–University of North Carolina (RTI-UNC) Evidence-based Practice Center under Contract No. 290-02-0016-I). Rockville, MD: Agency for Healthcare Research and Quality; September 2011. AHRQ Publication No. 11-EHC056-EF. Available at: http://www.effectivehealthcare.ahrq.gov/trd.cfm.
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