Efficacy of repetitive transcranial magnetic stimulation in depression: A review of the evidence

• Published in: Nordic journal of psychiatry Vol. 57; no. 3; pp. 227 - 232
• Main Authors: Aarre, T. F., Dahl, A. A., Johansen, J. B., Kjønniksen, I., Neckelmann, D.
• Format: Journal Article
• Language: English
• Published: England Informa UK Ltd 2003; Taylor & Francis
• Subjects: Antidepressive Agents - therapeutic use; Clinical Trials as Topic; Combined Modality Therapy; Controlled studies; Depression; Depressive Disorder - diagnosis; Depressive Disorder - psychology; Depressive Disorder - therapy; Electroconvulsive Therapy; Humans; Review; Transcranial magnetic stimulation; Transcranial Magnetic Stimulation - therapeutic use; Treatment Outcome
• ISSN: 0803-9488; 1502-4725
• DOI: 10.1080/08039480310001409

Repetitive transcranial magnetic stimulation (rTMS) is a novel treatment in psychiatry. We
reviewed all published evidence on the efficacy of this treatment option in depressive disorders.
An extensive electronic and manual search for eligible research reports identified only 12 studies
that met the predetermined criteria for inclusion. rTMS was administered differently in most
studies, and patient characteristics varied widely. A formal meta-analysis of the studies was thus
not possible. Instead, we conducted a qualitative evaluation of the included studies. The
antidepressive efficacy was not consistent, and where efficacy was demonstrated, it was modest
in most studies. Some patients had good but transient responses to rTMS. Treatment gains were
not maintained beyond the treatment period. Comparisons with electroconvulsive therapy
(ECT) indicated the superiority of ECT. More, larger and more carefully designed studies are
needed to demonstrate convincingly a clinically relevant effect of rTMS. We conclude that there
is insufficient evidence for rTMS as a valid treatment for depression at present.