A 240-patient randomized trial published in JAMA Psychiatry found that a single accelerated session of intermittent theta burst stimulation, delivered in the emergency department within four hours of psychiatric assessment, produced clinically meaningful reductions in suicidal ideation at 24 hours compared with sham stimulation.
The trial enrolled patients presenting to three urban EDs with acute suicidal ideation but no immediate plan or means. Patients in the active arm received 10 brief iTBS sessions over a six-hour stay; sham patients received the same time and clinical attention without active stimulation. Suicidal ideation scores on the Beck Scale dropped by an average of 11 points in the active arm versus 4 points in sham.
Effects appeared to last roughly 72 hours, suggesting the protocol could serve as a bridge to outpatient psychiatric care during the highest-risk window after discharge. Two-thirds of active-arm patients voluntarily enrolled in outpatient follow-up, compared with 41% in sham.
The authors caution this is not a replacement for inpatient psychiatric care for patients with acute plans or means, and that the protocol requires emergency department staffing changes that may not be feasible in smaller hospitals. Larger confirmatory trials are planned at six VA medical centers.
Source
Reporting based on coverage from JAMA Psychiatry. This article is editorial summary intended for general information; it is not medical advice.