Is it time to introduce repetitive transcranial magnetic stimulation into standard clinical practice for the treatment of depressive disorders?
Fitzgerald P.
Aust N Z J Psychiatry. 2003 Feb;37(1):5-11; discussion 12-4.

Alfred Psychiatry Research Centre, The Alfred and Monash University Department
of Psychological Medicine, Prahan, Victoria, Australia.

OBJECTIVE: To examine issues relating to the potential introduction of
repetitive transcranial magnetic stimulation (rTMS) into clinical practice as a
treatment for depression. METHOD: A review of the outcomes literature
accompanied by an analysis of issues relating to the potential advantages and
pitfalls of the introduction of rTMS as a treatment strategy. RESULTS: Evidence
is progressively accumulating that rTMS has antidepressant properties that are
clinically relevant. These effects are biologically plausible and supported by
basic research. Patients with therapy-resistant depression have few treatment
alternatives and experience significant suffering, thus justifying the early
introduction of a new treatment such as rTMS for this patient group. However,
this must be balanced by a need to foster considerable further research and not
to raise expectations unreasonably. CONCLUSIONS: It is timely for rTMS to be
made more available to patients with treatment-resistant mood disorders. This
need not be limited to clinical research trials but should only occur in medical
settings where continual evaluation and research is conducted.




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