new directions behavioral health llcmedicalpolicy.bluekc.com/medpolicylibrary/behavioral...the...

Repetitive Transcranial Magnetic Stimulation of 13

NEW DIRECTIONS BEHAVIORAL HEALTH, L.L.C.

Medical Policy

Repetitive Transcranial Magnetic Stimulation for Treatment of Major Depression

Original Effective date: 10/13/2014

Reviewed: 3/2015, 11/2015, 11/2016, 10/2017, 9/2018 Revised: 12/2016, 10/2017, 9/2018

PURPOSE: To provide practice parameters for repetitive Transcranial Magnetic Stimulation (rTMS) so that benefits are applied in a consistent and relevant fashion. This document applies to the use of rTMS in Treatment Resistant Depression

(TRD), which is the only indication for this device in psychiatric disorders. rTMS is not a first line treatment of depression, even for those with severe depression. This document addresses only rTMS treatment requests for depression. This

document is not meant to serve as a standard of care. DEFINITIONS:

1. Repetitive Transcranial Magnetic Stimulation (rTMS) was developed in 1985, and was

initially a research tool used to non-invasively probe neurologic function in the cortex. The procedure consists of placing an electromagnetic coil on the scalp. A powerful AC

current is passed through the coil. This results in a rapidly fluctuating intense magnetic field, which changes ionic flow in neural tissue located below the coil. The frequency of the fluctuation can also be manipulated. “Fast” rTMS is delivered at frequencies of 3 to

20 Hz. By contrast, “slow” rTMS is defined as a frequency of less than 1 Hz. In late 2008, the Food and Drug Administration (FDA) approved the NeoPulse device,

now known as NeuroStar rTMS, marketed by Neuronetics. Since that time, other

machines have also been approved for safety. The original FDA device approval indication is for treatment of depression in adult patients who have failed one 6-week course of an antidepressant. This approval was done under a 501K submission,

demonstrating safety, but not substantial equivalence in efficacy. According to FDA documents, both the Brain Way Deep TMS systems and the NeuroStar TMS Therapy System are currently indicated for the treatment of Major Depressive Disorder in adult patients who have failed to receive satisfactory improvement from prior antidepressant

medication in the current depressive episode. rTMS has been explored in migraine, spinal cord injury, tinnitus, mania, anxiety,

movement disorders, pain, OCD and auditory hallucinations in schizophrenia.


The side effects of rTMS are local discomfort at the site of the magnetic field, muscle twitching and headaches. If the frequency is too great, seizures will develop. In fact, this

has already been tried as an alternative to the electrical induction of seizures in electroconvulsive therapy (ECT). Magnetic Seizure Therapy (MST) is currently in its research infancy.

2. Navigated Transcranial Magnetic Stimulation (nTMS) is being studied as a diagnostic

tool to stimulate functional cortical areas at precise anatomical locations to induce measurable responses. This technology is being investigated to map functionally

essential motor areas for diagnostic purposes and for treatment planning. nTMS is considered experimental and investigational.

POLICY: A. Requests for rTMS

1. Requests for rTMS will be completed on the rTMS Initial Treatment Request Form

and/or the rTMS Continuation Request Form. These documents provide pertinent

clinical information about the patient’s past and current treatment history and response. Timelines for receiving information, making determinations, and peer review if needed will follow standard New Directions’ timeframes.

B. Treatment and Authorization Codes

1. rTMS is considered medically necessary when one treatment session per day is given for

five days per week for six weeks. Immediately following the six-week treatment period, the treatment frequency is tapered, as follows:

a. Week One: 3 treatment sessions b. Week Two: 2 treatment sessions c. Week Three: 1 treatment session

2. These Current Procedural Terminology (CPT) codes will be used in following manner:

a. 90867: Therapeutic repetitive transcranial magnetic stimulation (TMS) treatment; initial, including cortical mapping, motor threshold determination, delivery and management. (Report only once per course of treatment). (Do not report 90867 in conjunction with 90868, 90869, 95860-95870, 95928, 95929, 95939)

b. 90868: Subsequent delivery and management, per session a. 90869: Subsequent motor threshold re-determination with delivery and

management (Do not report 90869 in conjunction with 90867, 90868, 95860-95870,

95928, 95929, 95939) C. Certification Guideline


Must meet both 1 and 2:

1. Transcranial magnetic stimulation (including rTMS) of the brain administered with an FDA-approved device meets the definition of medical necessity as a treatment of major depressive disorder when ALL of the following criteria (sections a-f) have been met.

a. Confirmed diagnosis of severe major depressive disorder (ICD9 codes and 296.2x and 296.3X, WITHOUT psychosis) documented by one clinically accepted depression rating scale from the following list. [One test should be chosen and employed during the entire treatment course.]

TABLE 1

Name of test Number of items Minimum score for initial

Authorization Beck Depression Inventory (BDI)

21 >29

Inventory of Depressive Symptomatology Clinician-rated

(IDS-C)

30 >36

Quick Inventory of Depressive Symptomatology Self-reported

(QIDS-SR)

16 >15

Montgomery-Asberg Depression

Rating Scale (MADRS)

10 >34

Patient Health Questionnaire (PHQ9)

9 >19

b. The request is for a member between the ages of 18 and 70. c. The member is not actively abusing substances (UDS confirmation may be

required). d. The member has any one of the following:

i. Failure of four trials of psychopharmacologic agents approved by the FDA

for treating Major Depressive Disorder and at least 2 of these trials should use augmentation with an antidepressant. These must include:

1. Medicine trials from at least two different antidepressant

classes (for example SSRI, SNRI, TCA, MAI-O, etc.) 2. Two augmentation trials along with a primary

antidepressant. The FDA has approved augmentation

status for selected second generation antipsychotics, and the clinical literature has established other medications,


including but not limited to lithium and thyroid augmentation.

ii. Inability to tolerate a therapeutic dose of medications as evidenced by four trials of psychopharmacologic agents (consistent with d.i.1 and 2 above) with documented distinct intolerable side effects

iii. History of response to TMS in a previous depressive episode (at least three months since the prior episode)

iv. Is a candidate for electroconvulsive therapy (ECT), and ECT outcome would not be overall superior to TMS (e.g., in cases with psychosis, acute

suicidal risk, catatonia, or life-threating dysfunction in basic life needs, rTMS should not be utilized)

e. Failure of a trial of an evidence-based psychotherapy (e.g., CBT (cognitive

behavioral therapy), IPT (interpersonal therapy, etc.) known to be effective in the treatment of major depression. The definition of an adequate trial supported in the current medical literature is 8-12 sessions, without substantial

improvement in depressive symptoms, as documented by a significant difference between pre- and post-treatment scores on *standardized evidence-based depression rating scales that reliably measure depressive symptoms from the

following list: Beck Depression Inventory (BDI), Inventory of Depressive Symptomatology Clinician-rated (IDS-C16), Quick Inventory of Depressive Symptomatology Self-reported (QIDS-SR30), Montgomery-Asberg Depression

Rating Scale (MADRS), Patient Health Questionnaire9 (PHQ9) f. A 5-day a week treatment course of left dorsolateral prefrontal cortex TMS

treatment that lasts for six weeks (total of 30 sessions), followed by a three-week taper of three TMS treatment sessions in week 1, two TMS treatment

sessions the next week, and one TMS treatment session in the third and final week. Treatment frequency of less than five days/week will be reviewed for medical necessity.

g. Typical initial authorization will be for one unit of 90867 and 19 units of 90868. Concurrent authorization will be for 16 units of 90868, and one unit of 90869 if requested with necessary medical documentation.

2. Standardized depression rating scales should be performed during TMS treatment to

monitor progress at a minimal frequency of an initial pre-treatment test, followed by

testing every two weeks and a final test at the last treatment visit. These scores will be required for concurrent authorization. If the rating scales document a lack of meaningful change or worsening of symptom intensity, review by a physician advisor may be indicated.

D. Exclusions

1. The member has non-removable metallic objects or implants in his/her head or neck

regions.


2. The member has an active neurologic disorder, including but not limited to encephalopathy, dementia from any cause, Parkinson’s Disease, post-stroke syndromes,

increased intracranial pressure or bleeding, cerebral aneurysm, A-V malformations, CSF shunts, implants in the CNS or head/neck, etc.

3. There is evidence of active psychotic symptoms.

4. The request is for Maintenance rTMS Treatment. 5. The request is for treatment of OCD. In 2018, the FDA approved rTMS as a safe medical

device for treatment of Obsessive Compulsive Disorder (OCD). The current peer reviewed literature was reviewed does not support expanding the medical policy to

cover this diagnosis as an indication for rTMS. 6. The request is for Intermittent Theta Burst Stimulation (ITBS). In 2018, the FDA also

approved ITBS as a safe medical device for treatment resistant depression. The current

peer reviewed literature was reviewed does not support expanding the medical policy to cover this diagnosis as an indication for ITBS.

A. Training and Requirements

1. The attending physician is a board-certified psychiatrist with training in the use of rTMS in Major Depression.

2. The attending physician is required to personally perform codes 90867 and 90869.

3. Code 90868 may be administered by a technician, but this individual is required to have certification in administering rTMS.

4. New Directions will register any clinics or practitioners via documentation of certification, prior to allowing use of this benefit.

REFERENCES

Al-Harbi K.S. Treatment-resistant depression: therapeutic trends, challenges, and future directions. Patient Prefer Adherence 2012; 6: 369-388.

Allan C.L., Herrmann L.L., Ebmeier K.P. Transcranial magnetic stimulation in the management of mood disorders. Neuropsychobiology 2011; 64(3):163-169.

Avery, D.H., Holtzheimer, P. E., Fawaz, W., Russo, J., Neumaier, J., Dunner, D. L., Haynor, D. R., Claypoole, K. H., Wajdik, C., and Roy-Byrne, P. (2006). A controlled study of repetitive transcranial magnetic stimulation in medication-resistant major depression. Biological Psychiatry, 59 (2), 187-194.


Avery D.H., Isenberg K.E., Sampson S.M., et al. Transcranial magnetic stimulation in the acute treatment of major depressive disorder: clinical response in an open-label extension trial.

Journal of Clinical Psychiatry 2008; 69(3): 441-451. Bauer M., Bschor T., Pfennig A., et al. World Federation of Societies of Biological Psychiatry

(WFSBP) Guidelines for Biological Treatment of Unipolar Depressive Disorders in Primary Care. World Journal of Biological Psychiatry 2007; 8(2): 67-104.

Benadhira R1, Thomas F2, Bouaziz N2, Braha S2, Andrianisaina PS2, Isaac C2, Moulier V2, Januel D2

A randomized, sham-controlled study of maintenance rTMS for treatment-resistant depression

(TRD) Psychiatry Res. 2017 Dec;258:226-233. doi: 10.1016/j.psychres.2017.08.029. Epub 2017 Aug 18.

Daniel M Blumberger, MD, Fidel Vila-Rodriguez, MD, Kevin E Thorpe, MMath, Kfir Feffer, MD, Yoshihiro Noda, MD, Peter Giacobbe, MD, et al. Effectiveness of theta burst versus high-frequency repetitive transcranial magnetic stimulation in patients with depression (THREE-D): a

randomised non-inferiority trial. The Lancet, Volume 391, ISSUE 10131, P1683-1692, April 28, 2018. DOI:https://doi.org/10.1016/S0140-6736(18)30295-2

Blue Cross Blue Shield Association Medical Policy Reference Manual Transcranial magnetic

stimulation as a treatment of depression (2.01.50), 06/14.

Blue Cross Blue Shield Association Technology Evaluation Center (TEC). Transcranial magnetic

stimulation for depression. TEC Assessment 2014; Vol. 28, No. 9.

Blue Cross Blue Shield Association Technology Evaluation Center (TEC). Transcranial magnetic stimulation for depression. TEC Assessment 2011; Vol. 26, No. 5.

Blue Cross Blue Shield Association Technology Evaluation Center (TEC). Transcranial magnetic stimulation for the treatment of schizophrenia. TEC Assessment 2011; Vol. 26, No. 6.

Burt, T., Lisanby, S. H., Sackeim, H.A. (2002). Neuropsychiatric applications of transcranial magnetic stimulation: a meta-analysis. The International Journal of Neuropsychopharmacology, 5 (1), 73-103.

Cocchi L1, Zalesky A2,3, Nott Z1, Whybird G1, Fitzgerald PB4, Breakspear M1

Neuroimage Clin. 2018 May 23;19:661-674. doi: 10.1016/j.nicl.2018.05.029. eCollection 2018.

Transcranial magnetic stimulation in obsessive-compulsive disorder: A focus on network mechanisms and state dependence. Dowd, S., et. al. (2002). Is repetitive Transcranial Magnetic Stimulation an alternative to ECT for

the treatment of Depression? Contemporary Psychiatry, 1, 1-9.


ECRI Emerging Technology Evidence Report. Repetitive Transcranial Magnetic Stimulation Using the NeuroStar System for Treating Major Depressive Disorder, April 2012.

Eranti S., Mogg A., Pluck G., et al. A randomized controlled trial with 6-month follow-up repetitive transcranial magnetic stimulation and electroconvulsive therapy for severe

depression. American Journal of Psychiatry 2007; 164(1): 73-81.

First Coast Service Options LCD Transcranial magnetic stimulation for major depressive disorder L33676, 07/07/14.

Fitzgerald, P.B., Benitez, J., de Castella, A., Daskalakis, Z. J., Brown, T. L., and Kulkarni, J. (2006). A randomized, controlled trial of sequential bilateral repetitive transcranial magnetic

stimulation for treatment-resistant depression. American Journal of Psychiatry, 163 (1), 88-94. Fitzgerald, P.B., Brown, T. L., Marston, N. A. U., Daskalakis, Z. J., de Castella, A., and Kulkarni, J.

(2003). Transcranial magnetic stimulation in the treatment of depression: a double -blind, placebo-controlled trial. Archives of General Psychiatry, 60 (10), 1002-1008.

Fitzgerald, P.B., Huntsman, S., Gunewardene, R., Kulkarni, J., Daskalakis, Z. J. (2006). A randomized trial of low-frequency right-prefrontal-cortex transcranial magnetic stimulation as augmentation in treatment-resistant major depression. International Journal of

Neuropsychopharmacology, 9 (6), 655-666. Fochtmann L.J. and Gelenberg A.J. Guideline Watch: Practice guideline for the treatment of patients with major depressive disorder, 2nd Edition. FOCUS: The Journal of Lifelong Learning in

Psychiatry, Vol. 3, No. 1 Winter 2005:34-42.

Forde F1, Frame M, Hanlon P, MacLean G, Nolan D, Shajahan P, Troy E (2005) Optimum number of sessions for depression and anxiety. Nurs Times. Oct 25-31;101(43):36-40.

Gaynes B.N., Lux L., Lloyd S., et al. Nonpharmacologic interventions for treatment-resistant

depression in adults. Comparative effectiveness Review No. 33. AHRQ Publication No. 11-EHC056-EF. Rockville, MD: Agency for Healthcare Research and Quality. Sept 2011.

Gelenburg. A. (2000). Vagal nerve stimulation and repetitive transcranial magnetic stimulation for treatment resistant depression. Biological Therapies in Psychiatry, 23, 1819.

Gelenberg A.J., freeman M.P., Markowitz J.C., et al. Practice guideline for the treatment of patients with major depressive disorder, third edition, approved May 2010 and published Oct 2010.

George, M., et. al. (2003). Mechanisms and current state of Transcranial Magnetic Stimulation. CNS Spectrums, 8, 496-514.


George M.S., Lisanby S.H., Avery D., et al. Daily left prefrontal transcranial magnetic stimulation therapy for major depressive disorder: a sham-controlled randomized trial. Archives of General

Psychiatry 2010; 67(5):507-516.

George M.S., Post R.M. Daily left prefrontal repetitive transcranial magnetic stimulation for acute treatment of medication-resistant depression. Treatment in Psychiatry 2011; 168(4): 356-

364.

Gershon, A., Pinhas, N., & Gurnhaus, L. (2003). Transcranial Magnetic Stimulation in the

treatment of depression. American Journal of Psychiatry, 160 (5), 835-845. Grunhaus, L., Schreiber, S., Dolberg, O. T., Polak, D., and Dannon, P. N. (2003). A randomized controlled comparison of electroconvulsive therapy and repetitive transcranial magnetic

stimulation in severe and resistant nonpsychotic major depression. Biological Psychiatry, 53 (4), 324-331.

Haesebaert F1,2, Moirand R1,2, Schott-Pethelaz AM3, Brunelin J1,2, Poulet E1,2,4

Usefulness of repetitive transcranial magnetic stimulation as a maintenance treatment in patients with major depression. World J Biol Psychiatry. 2018 Feb;19(1):74-78. doi:

10.1080/15622975.2016.1255353. Epub 2016 Nov 23. Han Cuilan, Chen Zhongming, Liu Lin (2018). Commentary: Effectiveness of theta burst vs. high-

frequency repetitive transcranial magnetic stimulation in patients with depression (THREE-D): a randomized non-inferiority trial. Frontiers in Human Neuroscience. 25 June 2018 doi: 10.3389/fnhum.2018.00255.

Hasey, G. (2001). Transcranial magnetic stimulation in the treatment of mood disorder: a review and comparison with electroconvulsive therapy. Canadian Journal of Psychiatry, 46 (8),

720-727. Hausmann, A., Kemmler, G., Walpoth, M., Mechtcheriakov, S., Kramer-Reinstadler, K., Lechner, T., Walch, T., Deisenhammer, E. A., Kofler, M., Rupp, C. I., Hinterhuber, H., and Conca, A. (2004).

No benefit derived from repetitive transcranial magnetic stimulation in depression: a prospective single centre, randomized, double blind, sham controlled “add on” trial. Journal of Neurology, Neurosurgery & Psychiatry, 75 (2), 320-322.

Hawken Emily R., Dilkov Dancho, Kaludiev Emil, Simek, Selcuk, Zhang Felicia, Mil ev Roumen. (2016). Transcranial magnetic stimulation of the supplementary motor area in the treatment of

obsessive-compulsive disorder: A multi-site study. International Journal of Molecular Sciences, 17, 420.

Health Quality Ontario. Repetitive transcranial magnetic stimulation for treatment-resistant depression: a systematic review and meta-analysis of randomized controlled trials. Ont Health Technol Assess Ser [Internet]. 2016 March; 16(5):1-66. Available from:


http://www.hqontario.ca/evidence/publications-and-ohtac-recommendations/ontario-health-technology-assessment-series/sys-rev-rtms.

Holtzheimer, P. E., Russo, J., and Avery, D.H. (2001). A meta-analysis of repetitive transcranial magnetic stimulation in the treatment of depression. Psychopharmacology Bulletin, 35 (4), 149-

169. Hoppner, J., Schulz, M., Irmisch, G., Mau, R., Schlafke, D., and Richter, J. (2003). Antidepressant efficacy of two different rTMS procedures. High frequency over left versus low frequency over

right prefrontal cortex compared with sham stimulation. European Archives of Psychiatry and Clinical Neuroscience, 253 (2), 103-109. Howard, K. I., Kopta, S. M., Krause, M. S., & Orlinsky, D. E. (1986). The dose–effect relationship in psychotherapy. American Psychologist, 41(2), 159-164. http://dx.doi.org/10.1037/0003-066X.41.2.159

http://www.apa.org/about/policy/resolution-psychotherapy.aspx

https://www.cadth.ca/transcranial-magnetic-stimulation-treatment-adults-PTSD-GAD-Depression

https://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=34869

Institute for Clinical Systems Improvement (ICSI). Major depression in adults for mental health care. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2004 May. 52 p.

Isenberg, K., Downs, D., Pierce, K., Svarakic, D., Farcia, K., Jarvis, M., North, C., and Kormos, T. C.

(2005). Low frequency rTMS stimulation of the right frontal cortex is as effective as high frequency rTMS stimulation of the left frontal cortex for antidepressant-free, treatment-resistant depressed patients. Annuals of Clinical Psychiatry, 17 (3), 153-159.

Janicak, P.G., Dowd, S. M., Martis, B., Alam, D., Beedle, D., Krasuski, J., Strong, M. J., Sharma, R., Rosen, C., and Viana, M. (2002). Repetitive transcranial magnetic stimulation versus

electroconvulsive therapy for major depression: preliminary results of a randomized trial. Biological Psychiatry, 51 (8), 659-667. Janicak P.G., Nahas Z., Lisanby S.H., et al. Durability of clinical benefit with transcranial magnetic

stimulation (TMS) in the treatment of pharmacoresistant major depression: assessment of relapse during a 6-month, multisite, open-label study. Brain Stimulation 2010; 3(4); 187-199.

Janicak P.G., O’Reardon J.P., Sampson S.M., et al. Transcranial magnetic stimulation in the treatment of major depressive disorder: a comprehensive summary of safety experience from acute exposure, extended exposure, and during reintroduction treatment. Journal of Clinical

Psychiatry 2008; 69(2): 222-232.


Jorge R.E., Moser D.J., Acion L., et al. Treatment of vascular depression using repetitive transcranial magnetic stimulation Archives of General Psychiatry 2008; 65(3): 268-276.

Kennedy S.H., Milev R., Giacobbe P., et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) Clinical guidelines for the management of major depressive disorder in adults. IV.

Neurostimulation therapies. Journal of Affective Disorders 2009; 114: S44-S53. Kobayashi M., Pascual-Leone A. Transcranial magnetic stimulation in neurology. Lancet Neurol.

2003; 2(3): 145-156.

Koerselman, F., Laman, D. M., van Duijn, H., van Duijn, M. A. J., and Willems, M. A. M. (2004). A 3-month follow-up, randomized, placebo-controlled study of repetitive transcranial magnetic stimulation in depression. Journal of Clinical Psychiatry, 65 (10), 1323-1329.

Lam R.W., Chan P., Wilkins-Ho M., et al. Repetitive transcranial magnetic stimulation for treatment-resistant depression: a systematic review and meta-analysis Canadian Journal of

Psychiatry 2008; 53(9): 621-631.

Lisanby, S., et. al. (2003). New developments in ECT and Magnetic Seizure Therapy. CNS Spectrums, 8, 529-536.

Ljaz S1, Davies P, Williams CJ, Kessler D, Lewis G, Wiles N. Psychological therapies for treatment-resistant depression in adults. Cochrane Database Syst Rev. 2018 May 14;5:CD010558. doi: 10.1002/14651858.CD010558.pub2.

Loo, C. K. and Mitchell, P. B. (2005). A review of the efficacy of transcranial magnetic stimulation treatment for depression, and current and future strategies to optimize efficacy.

Journal of Affective Disorders, 88 (3), 255-267. Loo, C. K., Mitchell, P. B., Croker, V. M., Malhi, G. S., Wen, W., Gandevia, S. C., and Sachdev, P. S.

(2003). Double-blind controlled investigation of bilateral prefrontal transcranial magnetic stimulation for the treatment of resistant major depression. Psychological Medicine, 33 (1), 33-40.

Lusicic Ana1, Schruaers Koen R.J.2, Pallanti Stefano3,4, Castle David J. 3,4, (2018). Transcranial magnetic stimulation in the treatment of obsessive-compulsive disorder: current perspectives. Neuropsychiatric Disease and Treatment, 14, 1721-1736.

Ma Zhong-Rui, Shi Li-Jun, (2014). Repetitive transcranial mangnetic stimulation (rTMS) augmentation of selective serotonin reuptake inhibitors (SSRIs) for SSRI -resistant obsessive-

compulsive disorder (OCD): a meta-analysis of randomized controlled trials. International Journal of Clinical and Experimental Medicine. 7(12), 4897-4905.


Martin J.L., Barbanoj M.J., Schlaepfer T.E. et al. Repetitive transcranial magnetic stimulation for the treatment of depression. Systematic review and meta-analysis. British Journal of Psychiatry

2003; 182: 480-491.

Martin J.L.R., Barbanoj M.J., Pérez V., Sacristán M. Transcranial magnetic stimulation for the treatment of obsessive-compulsive disorder. The Cochrane Database of Systematic Reviews

2003, Issue 2. Art. No.: CD003387. DOI: 10.1002/14651858.CD003387.

Martin J.L.R., Barbanoj M.J., Schlaepfer T.E., Clos S., Perez V., Kulisevsky J., Gironell, A.

Transcranial magnetic stimulation for treating depression. The Cochrane Database of Systematic Reviews 2001, Issue 4. Art. No.: CD003493. DOI: 10.1002/14651858.CD003493.

McIntyre RS1, Filteau MJ2, Martin L3, Patry S4, Carvalho A5, Cha DS6, Barakat M7, Miguelez M7

Treatment-resistant depression: definitions, review of the evidence, and algorithmic approach.

J Affect Disord. 2014 Mar; 156:1-7. doi: 10.1016/j.jad.2013.10.043. Epub 2013 Nov 15. McLoughlin D.M., Mogg A., Eranti S., Pluck G., Purvis R., Edwards D., Landau S., Brown R., Rabe-Heskith S., Howard R., Philpot M., Rothwell J., Romeo R., Knapp M. The clinical effectiveness

and cost of repetitive transcranial magnetic stimulation versus electroconvulsive therapy in severe depression: a multicentre pragmatic randomised controlled trial and economic analysis. Health Technol Assess. 2007 Jul; 11(24): 1-54.

Minichino A., Bersani F.S., Capra E et al. ECT, rTMS, and deep TMS in pharmacoresistant drug-

free patients with unipolar depression: a comparative review. Neuropsychiatric Disease and Treatment 2012; 8:55-64.

Miniussi, C., Bonato, C., Bignotti, S., Gazzoli, A., Gennarelli, M., Pasqualetti, P., Tura, G. B., Ventriglia, M., Rossin, and P. M. (2005). Repetitive transcranial magnetic stimulation at high and low frequency: an efficacious therapy for major drug-resistant depression? Clinical

Neurophysiology, 116 (5), 1052-1071.

Miyasaki J.M., Shannon K., Voon V. et al. Practice parameter: Evaluation and treatment of depression, psychosis and dementia in Parkinson disease (an evidence -based review). American Academy of Neurology 2006; 66 (7): 996-1002.

Mohammad, Y. M., Kothari, R., Hughes, G., et al. Transcranial Magnetic Stimulation (TMS)

relieves migraine headache. Platform presentation at the American Headache Society annual scientific meeting in Los Angeles, June 23, 2006. Mosimann, U. P., Schmitt, W., Greenberg, B. D., Kosel, M., Muri, R. M., Berkhoff, Hess, C. W.,

Fisch, H. U. and Schlaepfer, T. E. (2004). Repetitive transcranial magnetic stimulation: a putative add-on treatment for major depression in elderly patients. Psychiatry Research, 126 (2) , 123-133.


Nakagawa A 1, Mitsuda D 2, Sado M 2, Abe T 3, Fujisawa D 2, Kikuchi T 4, Iwashita S 5, Mimura M 2, Ono Y 6 Effectiveness of Supplementary Cognitive-Behavioral Therapy for Pharmacotherapy-

Resistant Depression: A Randomized Controlled Trial. The Journal of Clinical Psychiatry [01 Sep 2017, 78(8):1126-1135]

National Institute for Health and Clinical Excellence. Depression in adults: The treatment and management of depression in adults, Oct 2009.

National Institute for Health and Clinical Excellence. Transcranial magnetic stimulation for

severe depression, Nov 2007.

New England Comparative Effectiveness Public Advisory Council (CEPAC). Coverage Policy Analysis: Repetitive transcranial magnetic stimulation (rTMS). Completed by: the Institute for

Clinical and Economic Review (ICER), June 2012.

O'Reardon, J.P., Solvason, H.B., Janicak, P.G., Sampson, S., Isenberg, K. E., Nahas, Z., McDonald, W. M., Avery, D., Fitzgerald, P. B., Loo, C., Demitrack, M. A., George, M. S., and Sackeim, H. A. (2007). Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major

depression: a multisite randomized controlled trial. Biological Psychiatry, 62 (11), 1208-1216.

Rachid, F1 (2018), Maintenance repetitive transcranial magnetic stimulation (rTMS) for relapse

prevention in with depression: A review. Psychiatry Res. April, 262:363-372. doi: 10.1016/j.psychres.2017.09.009. Epub 2017 Sep 19.

Rodriguez-Martin, J. L., Barbanoj, M. J., Schlaepfer, T. E., Clos, S. S. C., Perez, V., Kulisevsky, J., and Gironelli, A. (2001, October). Transcranial magnetic stimulation for treating depression. Cochrane Database of Systematic Reviews, 4. Available online at:

http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD003493/frame.html . Last accessed June 8, 2009. Rossini, D., Magri, L., Lucca, A., Giordani, S., Smeraldi, E., and Zanardi, R. (2005). Does rTMS

hasten the response to escitalopram, sertraline, or venlafaxine inpatients with major depressive disorder? A double-blind, randomized, sham-controlled trial. Journal of Clinical Psychiatry, 66 (12), 1569-1575.

Sachdev P.S., Loo C.K., Mitchell P.B. et al. Repetitive transcranial magnetic stimulation for the

treatment of obsessive compulsive disorder: a double-blind controlled investigation Psychological Medicine 2007; 37(11): 1645-1649.

Schutter D.J. Antidepressant efficacy of high-frequency transcranial magnetic stimulation over the left dorsolateral prefrontal cortex in double-blind sham-controlled designs: a meta-analysis Psychological Medicine 2009; 39(1): 65-75.

http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD003493/frame.html


Tranulis C., Sepehry A.A., Galinowski A. et al. Should we treat auditory hallucinations with repetitive transcranial magnetic stimulation? A meta-analysis Canadian Journal of Psychiatry

2008; 53(9): 577-586. van Bronswijk S1, Moopen N2, Beijers L3, Ruhe HG4, Peeters F1. (2018)Effectiveness of

psychotherapy for treatment-resistant depression: a meta-analysis and meta-regression. Psychological Medicine, Aug 24,1-14. doi: 10.1017/S003329171800199X. [Epub ahead of print]

new directions behavioral health llcmedicalpolicy.bluekc.com/medpolicylibrary/behavioral...the...

Documents