Efficacy of repetitive transcranial magnetic stimulation in depression: A review of the evidence.
Aarre TF, Dahl AA, Johansen JB, Kjonniksen I, Neckelmann D.
Nord J Psychiatry. 2003;57(3):227-32

Repetitive transcranial magnetic stimulation (rTMS) is a novel treatment in
psychiatry. We reviewed all published evidence on the efficacy of this treatment
option in depressive disorders. An extensive electronic and manual search for
eligible research reports identified only 12 studies that met the predetermined
criteria for inclusion. rTMS was administered differently in most studies, and
patient characteristics varied widely. A formal meta-analysis of the studies was
thus not possible. Instead, we conducted a qualitative evaluation of the
included studies. The antidepressive efficacy was not consistent, and where
efficacy was demonstrated, it was modest in most studies. Some patients had good
but transient responses to rTMS. Treatment gains were not maintained beyond the
treatment period. Comparisons with electroconvulsive therapy (ECT) indicated the
superiority of ECT. More, larger and more carefully designed studies are needed
to demonstrate convincingly a clinically relevant effect of rTMS. We conclude
that there is insufficient evidence for rTMS as a valid treatment for depression
at present.




em Psiquiatría