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Final project - Essay Example

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Evaluating the Efficacy of Transcranial Magnetic Stimulation For The Treatment Of Patients with Major Depressive Disorder: A Mulicentric Analysis Background of the Study Major depressive disorder (MDD) is perhaps the most widely experienced of psychiatric disorders…
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Download file to see previous pages The main conditions found in comorbidity to MDD includes Obsessive Compulsive disorder,Post Traumatic Stress Disorder and the Panic Disorders. (Kessler,1996) Currently the treatment of MDD is centred around the selective serotonin reuptake receptor inhibitors (SSRI). This is based on the fact the main mood elevator neurotransmitter of our body and found at synaptic junctions are actively reuptake so the availibilty of serotonin at the synapse decreases, reducing the mood and causing depression. SSRIs inhibits this uptake by inhibiting the reuptake receptors of serotonin in the presynaptic regions found in the nucleus accumbens and ventral tegmentum area and hence causing mood elevations. Although antidepressant medications are often prescribed to people with MDD, it is estimated that 20-40% of depressed people do not benefit from taking medication ( Kirsch 2008,Hays,1995)).Apart from the efficacy these medications can also cause side effects like drying of mouth, insomnia and others amongst the few. Thus, researchers are developing other possible ways to reduce depressive symptoms. One such depression treatment alternative to medication is the transcranial magnetic stimulation or TMS. Briefly, TMS treatment involves placing a coil on the scalp surface and passing a current through it (the exact details of the strength and rate of the current are beyond our purposes). When the current passes into neural tissue it affects the way the neurons operate, in a therapeutic way. Objective and Aim of the Study We wanted to analyze whether the TMS approach is effective in reduction of the episodes of depression from the baseline levels at the end of week 4 in the major depressive disorder patients. Methodology The study was conducted across multiple sites but the procedures were the same across locations. The sites involved were Florida, Oregon, and Washington. Across locations, participants with a history of antidepressant-resistant MDD were randomly assigned to either an active or a sham TMS condition. In the active condition, participants were actually given the TMS treatment. In the sham condition, participants were not given the TMS treatment but went through a similar procedure in each session (e.g., they came in for sessions in which a coil was placed on their heads but no current was run through it). So the sham condition was considered to be a type of placebo treatment. This was done to minimize the treatment limited bias of the study. The study was run double-blind so that neither the participant nor the assistant running the session was aware of which condition the participant was in. Thus the experimental design of the study was a randomized, multicentric, placebo controlled double blind study. This design definitely was important to give the way for a powerful analysis. The MADRS scores which is the set of scores that signifies the extent of depression of various parameters were analyzed to give a final depression score. The convention is, more the MADRS scores more is the depression and vice versa. Thus the results were analyzed by comparing the MADRS scores at baseline and at 4 weeks after the TMS treatments were implemented to see the effect of that approach on MDD patients. Statistical analysis was carried out through SPSS software and paired sample t test was carried to find out the levels of significance. P values less than 0.05 were considered statistically significant. Results We analyzed findings on 4 questions to reach a conclusion. Q1.Ignoring the TMS condition and ...Download file to see next pagesRead More
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