High Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) in the Treatment of Post-traumatic Stress Disorder (PTSD)

High Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) in the Treatment of Post-traumatic Stress Disorder (PTSD)

This is a double-blind, randomized, placebo-controlled study evaluating the efficacy and safety of high-frequency (20Hz) rTMS applied to the right dorsolateral prefrontal cortex for 6 weeks. The primary objective is to evaluate the change in PTSD symptoms before and after six weeks of high-frequency rTMS treatment as measured by the Clinician Administered PTSD Scale (CAPS) in both active and control groups.

Inclusion Criteria:

• Signed Patient Information and Consent.
• Patients with primary Post-Traumatic Stress Disorder (as diagnosed by MINI) and DSM IV TR.
• Patients with CAPS score of at least 40.
• Males or females between 18-65 years of age.
• Patients not taking PTSD pharmacotherapy for at least last 2 weeks prior to commencing in the study or if they are taking PTSD pharmacotherapy it must be stable for at least 6 weeks prior to the start and not be changed during the 6 weeks of the study treatment phase.
• Individual or group supportive psychotherapy may continue during the study but will not be allowed to start new psychotherapy during the 6 weeks of the study treatment phase.

Exclusion Criteria:

• Current primary Axis I disorder including Schizophrenia, Bipolar Disorder type I, Major Depressive Disorder.
• Other primary Axis I disorders which, in the opinion of the investigator, may affect the outcome of this study.
• Patients with HDRS score ≥ 18.
• A metallic implant in cranium (except the mouth).
• Patients with severe or unstable medical conditions, which in the opinion of the investigator would interfere with their progress or safety.
• ECT treatment within the last three months.
• Patients with a history of epilepsy.
• Patients with neurological disorder leading to increased intracranial pressure.
• Patients with severe cardiac disorder or intracardiac lines and pacemakers.
• Patients with current suicide risk ≥ 6 points by MINI.