To Taper or Not to Taper: That is the Question

Background: Pharmacological treatments routinely end with a taper and tapering final TMS is common. In large registry, we examined (1) the frequency nature of for MDD patients, (2) potential associations use acute phase antidepressant efficacy, (3) relations to likelihood timing retreatment due symptomatic worsening. Methods: NeuroStar Outcomes Registry, 7,640 patients were identified PHQ-9 scores at baseline ± 4 days session. Patients classified into three groups: (a) Strict Taper: 1-2 session/wk last weeks (N=938, 12.3%); (b) Loose received > 2 < 3 (N=1,313, 17.2%), (c) No Taper (N=5,389, 70.5%). Results: Approximately 30% sample was tapered. The Group (Strict Loose) had slightly more severe symptoms, sessions in course lower density per week. duration considerably longer (Avg. 17.3 days). There no evidence that receiving improved clinical outcomes or prevented delayed retreatment. Conclusions: This an open-label, naturalistic study did not find beneficial protective. Use associated treatment duration. decision may be based on other factors such as need monitor progress. However, does appear impact durability. Conflicts Interest: Dr. Sackeim serves scientific adviser receives consulting fees from Cerebral Therapeutics Inc, Holmusk LivaNova PLC, MECTA Corporation, Neurolief LTD, Neuronetics Parow Entheobiosciences LLC SigmaStim LLC. He honoraria royalties Elsevier Inc Oxford University Press. inventor non-remunerative US patents Focal Electrically-Administered Seizure Therapy (FEAST), titration current domain ECT, adjustment ECT devices, each held by also originator magnetic seizure therapy (MST). Aaronson Genomind Janssen Pharmaceuticals Sage has research support Compass Pathways Inc. Drs. Hutton, Pages, West serve consultants Funding: work supported Disclosures: None