Affiliations: Department of Psychiatry and Psychotherapy III,
University of Ulm, Ulm, Germany | Psychiatric University Hospital Zürich, Zürich, Switzerland
Note: [] Corresponding author: PD Dr. C. Schönfeldt-Lecuona, MD,
Department of Psychiatry and Psychotherapy III, University Clinic Ulm,
Leimgrubenweg 12, 98075 Ulm, Tel.: +49 731 500 61411; Fax: +49 731 500 61412;
E-mail: carlos.schoenfeldt@uni-ulm.de
Abstract: Looking at novelties and advances in medicine in particular in the
treatment of major depressive disorder no principally new antidepressant
treatment strategy has been established in clinical routine in the last fifty
years. However, regarding the considerable issue of treatment resistance in
depression, new therapeutic strategies are urgently required. In this context,
repetitive transcranial magnetic stimulation above the dorsolateral prefrontal
cortex has been proposed as a potential new treatment option for depression;
furthermore, in October 2008 a first rTMS-device (NeuroStar TMS Therapy
System™) was approved by the FDA for the treatment
of treatment resistant major refractory depression in adults. Yet, despite now
nearly two decades of research in this field, no final answer concerning its
validity for antidepressant treatment in the clinical practice is given.
Numerous studies with small sample sizes and heterogeneous designs have been
performed in this field yielding to different results. These were subjected to
meta-analyses, assessing the antidepressant effect of rTMS, which are briefly
summarized in this article. Further, multicentre-trials with larger numbers of
patients were performed, which are presented and critically discussed here in
more detail. This short review shall thus provide an overview of the current
status of knowledge concerning rTMS in depression and it also provides some
recommendations for future research in this field.
Keywords: Depression, Repetitive transcranial magnetic stimulation, meta-analysis, antidepressant treatment trial
