Transcranial magnetic stimulation for the treatment of major depression

Abstract

Major depression is often difficult to diagnose accurately. Even when the diagnosis is properly made, standard treatment approaches (eg, psychotherapy, medications, or their combination) are often inadequate to control acute symptoms or maintain initial benefit. Additional obstacles involve safety and tolerability problems, which frequently preclude an adequate course of treatment. This leaves an important gap in our ability to properly manage major depression in a substantial proportion of patients, leaving them vulnerable to ensuing complications (eg, employment-related disability, increased risk of suicide, comorbid medical disorders, and substance abuse). Thus, there is a need for more effective and better tolerated approaches. Transcranial magnetic stimulation is a neuromodulation technique increasingly used to partly fill this therapeutic void. In the context of treating depression, we critically review the development of transcranial magnetic stimulation, focusing on the results of controlled and pragmatic trials for depression, which consider its efficacy, safety, and tolerability.

Management of depression in patients with schizophrenia spectrum disorders: a critical review of international guidelines

“…As CBT for depression, and especially its behavioural component , has shown interesting efficacy patterns in the active phase and relapse prevention in major depression , it would be interesting to investigate the noninferiority effect of antidepressant‐shaped CBT for PWS experiencing MDD. Other approaches that demonstrated a preliminary or well‐tried efficacy in depression also should be investigated in PWS, such as cognitive remediation and noninvasive brain stimulation techniques .…”

Reward Circuitry in Addiction

“…Research has also begun to translate findings from optogenetic studies in rodent models and apply them to human addicts. One strategy is to use repetitive transcranial magnetic stimulation (rTMS), as this is a noninvasive approach to alter neuronal activity that has been applied with success to other neuropsychiatric disorders such as depression [96]. Clinical trials using rTMS for addiction are ongoing, with studies investigating whether rTMS treatment is capable of decreasing craving for, or use of, multiple drugs of abuse, including alcohol, cocaine, methamphetamine, and tobacco [97].…”

The role of left prefrontal transcranial magnetic stimulation in episodic migraine prophylaxis

“…Regarding depressive symptoms, 91.9 % of the studied sample had no or mild depression using the Beck Depression Inventory. However, due to the fact that LDLPFC high-frequency rTMS has a known antidepressant effect [29], it might be useful in future studies to correlate mood changes with the prophylactic role of rTMS in migraine.…”