Repetitive transcranial magnetic stimulation for the treatment of depression. Systematic review and meta-analysis.
Martin JL, Barbanoj MJ, Schlaepfer TE, Thompson E, Perez V, Kulisevsky J.
Br J Psychiatry. 2003 Jun;182:480-91

BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) may be useful in
the treatment of depression but results from trials have been inconclusive to
date. AIMS: To assess the efficacy of rTMS in treating depression. METHOD: We
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 meta-analysis of data from trials with similar rTMS
delivery. RESULTS: We 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). CONCLUSIONS: Current trials are of low quality and provide
insufficient evidence to support the use of rTMS in the treatment of depression.




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