CHANGE IN REPORTED RESILIENCE AFTER REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (rTMS) FOR MAJOR DEPRESSIVE DISORDER AT A SUBURBAN TERTIARY CLINIC

Background: Repetitive transcranial magnetic stimulation (rTMS) is a neurostimulatory technique approved for the treatment of major https://doi.org/10.1016/j.brs.2021.07.023 depressive disorder (MDD) impacting orbital frontal cortex functioning. We have previously identified significant changes in ratings for several standard metrics for depression, anxiety, pain and ADHD after 6 weeks of standard rTMS therapy. Objective/Hypothesis:We examined the effects of rTMS for the treatment of MDD on resilience measured using the Brief Resilience Inventory. Design/Methods: A retrospective review of medical records was carried out on patients with MDD undergoing rTMS therapy at AwakeningsKC Clinical Neuroscience Institute (CNI), a suburban tertiary psychiatric clinic. A detailed de-identified data set of clinical outcomes was compiled. Brief Resilience Scale, Montgomery-Åsberg Depression Rating Scale (MADRS); Patient Health Questionnaire 9 (PHQ-9) total scores were evaluated over 6 weeks of treatment to assess clinical response. Results: Our survey included 62 participants [N1⁄426 males, N1⁄436 females] with average baseline PHQ-9 scores of 16.3±6, classified as “moderately severe depression”. Baseline BRS scores increased significantly from 2.1±0.86 at baseline to 2.7±0.78 at week 6 (mean 1⁄4 0.46, 95% CI 0.18-0.73, t1⁄43.4, p<0.001). The response was inversely correlated with the change in MADRS (28.6±8 Baseline; 15.5±11 Week 6; r1⁄4 -0.5; p<0.001) and PHQ9 (r1⁄4 -0.42, p<0.01). Conclusions: rTMS for MDD was associated with a significant increase in resiliency that correlated with mood change after 6 weeks of standard therapy. Conflicts of Interest and Funding Source: Dr. Davila is the owner of AwakeningsKC, Amelia Hess and Ananya are employed by AwakeningsKC. KETAMINE THERAPY COMBINED WITH REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (RTMS) FOR MAJOR DEPRESSIVE DISORDER AT A SUBURBAN TERTIARY CLINIC Maria Cristina Davila , Amelia Hess , Ananya Louviere , Ann M. Manzardo . AwakeningsKC Clinical Neuroscience Institute Department of Psychiatry & Behavioral Sciences, University of Kansas Medical Center Abstract Background: Ketamine is a dissociative anesthetic with antidepressant effects at low doses recently approved by the FDA for the treatment of severe depression. This novel application of ketamine has not been studied in combinationwith repetitive transcranial magnetic stimulation (rTMS), a neurostimulatory technique approved for the treatment of major depressive disorder (MDD) impacting orbital frontal cortex functioning. Objective/Hypothesis:We examined outcomes of patients withMDD after combined rTMS and Ketamine therapy to consider safety and effectiveness in an outpatient setting. Design/Methods: A retrospective review of medical records was carried out on patients with MDD undergoing combined Ketamine and rTMS therapy at AwakeningsKC Clinical Neuroscience Institute (CNI), a suburban tertiary psychiatric clinic. A detailed de-identified data set of clinical outcomes was compiled. Patient Health Questionnaire 9 (PHQ-9) and Becks Depression Inventory total scores were evaluated over 6 weeks of treatment to assess clinical response. Results: Our survey included 29 patients [N1⁄4 17males, N1⁄4 12 females] with average baseline PHQ-9 scores of 17.5±5, classified as “severe depression”. Fifteen patients [N1⁄4 8males, N1⁄4 7 females] have completed 6 weeks of therapy to date. Among these, PHQ9 scores decreased by 8.8±6Background: Ketamine is a dissociative anesthetic with antidepressant effects at low doses recently approved by the FDA for the treatment of severe depression. This novel application of ketamine has not been studied in combinationwith repetitive transcranial magnetic stimulation (rTMS), a neurostimulatory technique approved for the treatment of major depressive disorder (MDD) impacting orbital frontal cortex functioning. Objective/Hypothesis:We examined outcomes of patients withMDD after combined rTMS and Ketamine therapy to consider safety and effectiveness in an outpatient setting. Design/Methods: A retrospective review of medical records was carried out on patients with MDD undergoing combined Ketamine and rTMS therapy at AwakeningsKC Clinical Neuroscience Institute (CNI), a suburban tertiary psychiatric clinic. A detailed de-identified data set of clinical outcomes was compiled. Patient Health Questionnaire 9 (PHQ-9) and Becks Depression Inventory total scores were evaluated over 6 weeks of treatment to assess clinical response. Results: Our survey included 29 patients [N1⁄4 17males, N1⁄4 12 females] with average baseline PHQ-9 scores of 17.5±5, classified as “severe depression”. Fifteen patients [N1⁄4 8males, N1⁄4 7 females] have completed 6 weeks of therapy to date. Among these, PHQ9 scores decreased by 8.8±6