Cost-Effectiveness of rTMS as a Next Step in Antidepressant Non-Responders: A Randomized Comparison With Current Antidepressant Treatment Approaches.

Background: Although repetitive transcranial magnetic stimulation (rTMS) is an effective and commonly used treatment option for treatment-resistant depression, its cost-effectiveness remains much less studied. In particular, the comparative cost-effectiveness of rTMS and other treatment options, such as antidepressant medication, has not been investigated.

Methods: An economic evaluation with 12 months follow-up was conducted in the Dutch care setting as part of a pragmatic multicenter randomized controlled trial, in which patients with treatment-resistant depression were randomized to treatment with rTMS or treatment with the next pharmacological step according to the treatment algorithm.

Mapping of the health of the Nation Outcomes Scale (HoNOS) and Positive and Negative Symptom Scale (PANSS) to the EQ-5D-3L in psychosis patients using the PHAMOUS study.

Objectives: When health outcomes relevant for economic evaluations are unavailable, algorithms can be developed to map utilities using available clinical outcome measures. This study aims to develop two mapping algorithms estimating EuroQol-5 dimension-3 level (EQ-5D-3 L) utilities using the clinician-rated Health of the Nation Outcome Scores (HoNOS) and Positive and Negative Syndrome Scale (PANNS).

Methods: A dataset with 2,029 observations of patients with psychotic disorders included EQ-5D-3 L, HoNOS, PANSS item scores, and demographics.

Antipsychotic dopamine D affinity and negative symptoms in remitted first episode psychosis patients.

Negative symptoms can be an integral part of schizophrenia spectrum pathology and can be secondary to other psychotic symptoms or caused by antipsychotic medication. As antipsychotic drugs differ in their affinity to dopamine receptors and some antipsychotics have partial agonistic effects, antipsychotic drugs are expected to vary in their ability to cause negative symptoms. The association between negative symptoms and antipsychotic medication divided into partial agonists, or antagonists with high or low D affinity was assessed in 310 remitted first episode psychosis (FEP) patients.

rTMS as a Next Step in Antidepressant Nonresponders: A Randomized Comparison With Current Antidepressant Treatment Approaches.

Objective: Although repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for depression, little is known about the comparative effectiveness of rTMS and other treatment options, such as antidepressants. In this multicenter randomized controlled trial, rTMS was compared with the next pharmacological treatment step in patients with treatment-resistant depression.

Methods: Patients with unipolar nonpsychotic depression (N=89) with an inadequate response to at least two treatment trials were randomized to treatment with rTMS or to a switch of antidepressants, both in combination with psychotherapy.