Real-world treatment outcomes of transcranial pulsating electromagnetic fields as augmentation therapy for treatment-resistant depression

Background: Treatment outcomes of patients who had received T-PEMF as an augmenting therapy at Aalborg University Hospital, Aalborg, Denmark, was evaluated. Methods: Patients diagnosed with unipolar depression or bipolar disorder who had received a self-administered 8-week T-PEMF series between November 2019 and April 2023 were included. Data were retrieved from the patients' records. The primary outcome was the Hamilton Rating Scale for Depression 17-item version (HAMD(17)), both as a continuous measure and with proportions of response and remission reported. Results: A total of 57 patients (65.1 % females, 86.0 % unipolar depression, mean age, 48 +/- 14 years) were included. Duration of current depressive episode was almost equally divided for <2 years (38.6 %), 2-5 years (38.6 %) and > 5 years (22.8 %). HAM-D-17 decreased significantly from baseline (20.8 (SD: 3.3)) to week 8 (14.5 (SD: 6.2), p < 0.001). An episode duration of 2-5 years was associated with lower odds of response on HAM-D-6 (adjusted OR = 0.15, 95 % CI: 0.03; 0.96, p < 0.05) and self-rated HAM-D-6 (adjusted OR = 0.09, 95 % CI: 0.01; 0.99, p = 0.05) when compared to an episode duration <2 years. Limitations: This study is limited by a lack of a control group, limited controlling of confounders, small sample sizes, and an attrition rate of 29.8 % for the primary outcome. Conclusion: T-PEMF reduced depressive symptoms in a real-world clinical setting including patients with both unipolar depression and bipolar disorder. Receiving T-PEMF within the first 2 years of the depressive episode was associated with an improved outcome.