Effects of Comorbid Anxiety on Treatment Outcomes After Accelerated Theta Burst Stimulation for Late-Life Depression

Am J Geriatr Psychiatry. 2025 Sep 20:S1064-7481(25)00485-3. doi: 10.1016/j.jagp.2025.09.017. Online ahead of print.

ABSTRACT

OBJECTIVES: Accelerated theta burst stimulation (TBS) offers a time-efficient alternative to conventional repetitive transcranial magnetic stimulation and has recently been explored in late-life depression (LLD). Anxiety symptoms frequently occur in depressed older adults and are known to reduce the effectiveness of first-line therapeutic options. The impact of anxiety symptoms on treatment outcomes from accelerated TBS is unknown.

METHODS: Secondary analyses were performed on data from an open-label pilot trial where 78 outpatients with LLD received a 5-day course of accelerated sequential bilateral TBS (NCT05119699).

RESULTS: Participants with a comorbid anxiety disorder had more severe depressive symptoms before and after treatment and lower remission rates at the 4-week follow-up, but not immediately at treatment end. Baseline anxiety symptoms did not significantly affect rates of remission from suicidal ideation at either follow-up time points.

CONCLUSIONS: Comorbid anxiety symptoms may reduce the effectiveness of accelerated TBS for treating depressive symptoms in older adults.

PMID:41109788 | DOI:10.1016/j.jagp.2025.09.017