Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a novel treatment in psychiatry. Wereviewed 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 studiesthat met the predetermined criteria for inclusion. rTMS was administered differently in moststudies, and patient characteristics varied widely. A formal meta-analysis of the studies was thusnot possible. Instead, we conducted a qualitative evaluation of the included studies. Theantidepressive efficacy was not consistent, and where efficacy was demonstrated, it was modestin most studies. Some patients had good but transient responses to rTMS. Treatment gains werenot maintained beyond the treatment period. Comparisons with electroconvulsive therapy(ECT) indicated the superiority of ECT. More, larger and more carefully designed studies areneeded to demonstrate convincingly a clinically relevant effect of rTMS. We conclude that thereis insufficient evidence for rTMS as a valid treatment for depression at present.
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