Deep TMS for Smoking Cessation: Outcomes From a Phase IV Registry Study of the H4 Coil

Methods: This double-blind randomized study offers an accelerated protocol dTMS treatment in the span of 10 treatment days.The study examined the efficacy of the dTMS accelerated protocol on suicidality indicators.This treatment was given in three arms, sham, active H1 coil and active H7 coil.Results: 39 patients were enrolled in the study.31 patients successfully completed 10 treatment days.Patients receiving active treatment (both H1 and H7) showed superior response (defined as > 50% improvement in depression scale) compared to sham (p = 0.02).Additionally, clinically close to significance improvement in suicidality intensity scales was found after 10 days of treatment in active treatment compared to placebo (p = 0.07).However, no significant difference was found regarding suicidality type scores.No major differences in depression and suicidality were found comparing H1 and H7 coils.Discussion: Active suicidality is a major challenge in treating severe mental disorders, and death by suicide is still a leading cause of death among patients.However, most clinical studies in mental health still exclude patients with active suicidality, hence treatment options are limited.In this study we found deep TMS accelerated protocol (H1 and H7 coils) to be both safe and effective in decreasing suicidality intensity and depression symptoms among inpatients with severe mental disorders accompanied by suicidality.