Document Type : Systematic review

Authors

1 DM Scholar, Geriatric Mental Health, King George's Medical University, Lucknow, UP, India

2 Geriatric Mental Health, King George Medical University, Lucknow, UP, India

3 Department of Psychiatry, King George Medical University, Lucknow, UP, India

4 King George Medical University, Lucknow, India

Abstract

Objective: Clinical utility of transcranial magnetic stimulation (TMS) in older adults with depression is less studied. This review was conducted with the aim to compile the study findings on efficacy and adverse effects of TMS in late-life depression, to elucidate gaps in the literature and to formulate recommendations.
Method: A search was conducted on PubMed, SCOPUS and OVID data bases with search terms based on the three domains of our research questions namely “transcranial magnetic stimulation” (TMS), “depression” and “late life”. All the articles published in English till June 2021 were incorporated and critically appraised after fulfilling inclusion and exclusion criteria.
Results: A total of 643 articles were screened with title and abstract and 41 were selected for full text assessment. Finally, 26 articles were included after scrutiny and findings were tabulated. This consisted of 8 Randomized Controlled Trials (RCTs), 6 Open label, 1 retrospective study, 4 case series and 7 case reports. Available findings in this area thus far, are mixed and inconclusive. Level I evidence for the use of TMS in late-life depression is lacking.
Conclusion: Evidence regarding efficacy of TMS in treatment of depression in older adults lacks consistency in the outcomes, which warrants urgent need for systematic review and metanalysis of RCTs on use of TMS in late life depression.

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