Using repetitive brain stimulation to treat major depression: an evidence review

Early meta-analyses suggested rTMS might be effective for treating major depressive disorder, but recent assessments concluded there is no evidence supporting its efficacy.

• Recent health technology assessments found no evidence that rTMS is effective for major depressive disorder, whether treatment-resistant or not.
• Methodological limitations, including small sample sizes and biased randomization, were common in studies evaluating rTMS.
• Variability in patient definitions and characteristics, such as treatment resistance and type of depression, complicates the interpretation of results.
• Short-term studies predominated, with most treatments lasting only 1 to 2 weeks, raising questions about long-term effectiveness.
• Statistical significance was often observed, but the clinical significance, defined as a 50% reduction in depression scores, was not consistently achieved.

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