rTMS linked to better scores than drug changes in late-life resistant depression

The edition in brief

An individual participant analysis combining two trials in 758 adults aged 60 or over with treatment-resistant depression found that bilateral rTMS was associated with MADRS scores 4 to 6 points lower at 10 weeks than aripiprazole augmentation, bupropion augmentation or a switch to bupropion, with roughly four-fold higher odds of response. The comparison crosses two separate trials and is observational, so it supports offering rTMS earlier rather than proving it superior. In the Avon cohort of 3,499 children, each additional positive childhood experience on a 10-point score was associated with 11% lower odds of a psychiatric disorder at 24, mainly depression. A five-year follow-up of three small choline trials in children with fetal alcohol spectrum disorder found medium-sized advantages in non-verbal IQ and working memory, from 58 children followed. The FDA lists an ongoing Class III recall of one manufacturer's olanzapine 5 mg tablets for out-of-specification impurities, which is a quality action, not a new safety signal. The pearl covers metabolic monitoring on antipsychotics.