Treating Depression With Repetitive Transcranial Magnetic Stimulation: A Clinician’s Guide
Shixie Jiang, MD
Published in: American Journal of Psychiatry
Read more: https://pubmed.ncbi.nlm.nih.gov/40302403/
What’s This Study About?
This clinician-focused review offers an up-to-date synthesis of the clinical application of transcranial magnetic stimulation (TMS) for major depressive disorder (MDD), with an emphasis on treatment-resistant depression (TRD). It summarizes FDA-cleared protocols, discusses recent innovations like bilateral stimulation, theta burst stimulation, and accelerated treatment schedules, and provides practical guidance on treatment setup, coil targeting, and safety considerations.
Key Findings:
- TMS is a well-tolerated, evidence-based treatment for TRD, with FDA-approved protocols now considered standard of care.
- Theta burst stimulation (TBS) offers equivalent efficacy to standard TMS protocols in a shorter time frame, increasing clinic efficiency.
- Real-world registry data suggest response rates of ~50%, with early symptom improvement and number of sessions correlating with outcomes.
- Alternative protocols (e.g., bilateral stimulation) and scheduling (e.g., accelerated TMS) provide flexibility for tailoring treatment to patient needs.
Why It Matters:
This article equips clinicians with a comprehensive, accessible overview of TMS practice, helping bridge the gap between research and real-world application. By distilling decades of evidence, it supports informed clinical decision-making and underscores the potential for TMS to improve outcomes in patients who have not responded to medications. As TMS technology evolves, the guide highlights the expanding role of neuromodulation in psychiatry.