Prefrontal repetitive transcranial magnetic stimulation as add on treatment in depression

A growing number of studies report antidepressant effects of repetitive tra nscranial magnetic stimulation (rTMS) in patients with major depression. Th e hypothesis that high frequency (20 Hz) rTMS (HF-rTMS) may speed up and st rengthen the therapeutic response to sertraline in MD was tested. Twenty ei ght patients who had not yet received medication for the present depressive episode (n=12) or had failed a single trial of an antidepressant medicatio n (n=16) were started on sertraline and randomised to receive either real o f sham HF-rTMS. HF-rTMS was applied to the left dorsolateral prefrontal are a in daily sessions (30 trains of 2 s, 20-40 s intertrain interval, at 90% motor threshold) on 10 consecutive working days. The results suggest that m i this patient population, HF-rTMS does not add efficacy over the use of st andard antidepressant medication.