Repetitive transcranial magnetic stimulation for the treatment of depression

Abstract

BackgroundRepetitive transcranial magnetic stimulation (rTMS) may be useful in the treatment of depression but results from trials have been inconclusive to date.AimsTo assess the efficacy of rTMS in treating depression.MethodWe conducted a systematic review of randomised controlled trials that compared rTMS with sham in patients with depression. We assessed the quality of design of all studies and conducted a metaanalysis of data from trials with similar rTMS delivery.ResultsWe included a total of 14 trials. The quality of the included studies was low. Pooled analysis using the Hamilton Rating Scale for Depression showed an effect in favour of rTMS compared with sham after 2 weeks of treatment (standardised mean difference=–0.35; 95% CI –0.66 to –0.04), but this was not significant at the 2-week follow-up (standardised mean difference= — 0.33; 95% CI —0.84 to 0.17).ConclusionsCurrent trials are of low quality and provide insufficient evidence to support the use of rTMS in the treatment of depression.