Therapeutic efficacy of right prefrontal slow repetitive transcranial magnetic stimulation in major depression - A double-blind controlled study

Background: Transcranial magnetic stimulation (TMS), a noninvasive techniqu e for stimulation of the brain, has recently been suggested to be effective for the treatment of major depression. We conducted a double-blind, placeb o-controlled study to assess the efficacy of slow repetitive TMS (rTMS) in patients with major depression. Methods: Seventy patients with major depression (53 women, 17 men; mean age , 58.7 years; SD, 17.2 years) were randomly assigned to receive rTMS or sha m rTMS in a double-blind design. Treatment was administered in 10 daily ses sions during a 2-week period. Severity of depression was blindly assessed b efore, during, and after completion of the treatment protocol. Results: All patients completed the first week of treatment and 67 complete d the entire protocol. Patients who received rTMS had a significantly great er improvement in depression scores compared with those who received sham t reatment. At the end of 2 weeks, 17 of 35 patients in the rTMS group, but o nly 8 of 32 in the sham-treated group, had an improvement of greater than 5 0% in their depression ratings. Conclusions: This controlled study provides evidence for the short-term eff icacy of slow rTMS in patients with recurrent major depression. Additional studies will be necessary to assess the efficacy of rTMS as compared with e lectroconvulsive therapy as well as the long-term outcome of this treatment in major depression and possibly other psychiatric disorders.