Study Explores Efficacy of rTMS on Response and Remission Rates in Patients With TRD

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A study found that repetitive transcranial magnetic stimulation (rTMS) is more effective than sham rTMS in response and remission outcomes in patients with treatment-resistant depression (TRD). The investigators also concluded that rTMS may be effective as an adjunctive treatment for patients with major depressive disorder (MDD).

The study, a meta-analysis of randomized sham-controlled trials, aimed to analyze the literature examining the efficacy of adjunctive rTMS treatment in the management of TRD and the ways methodological issues may affect its efficacy as an add-on treatment.¹

The investigators performed a systematic literature search of English-language randomized, double-blind, sham-controlled trials investigating rTMS in comparison with pharmacotherapy in adult patients with unipolar TRD published between January 2000 and March 2022 on the Scopus and PubMed databases. They identified 19 studies that fit all eligibility criteria for quantitative analysis of response (n = 854 patients) and 9 studies for remission (n = 551 patients) in adult patients with TRD following 2 antidepressant failures.¹

The investigators found that the risk ratios for response and remission and response were 2.25 and 2.78, respectively, for patients after 2 treatment failures using rTMS as add-on treatment in comparison with standard pharmacotherapy. They reported that Cochrane’s Q test identified no significant heterogeneity, and that they did not detect publication bias.¹

“Several meta-analyses proved the efficacy of rTMS treatment in MDD, which is comparable to pharmacotherapy, and may have even better tolerability,” the investigators concluded. “Our results strengthened that rTMS is associated with clinically relevant antidepressant effect in TRD as well and may be a beneficial tool in the add-on treatment of patients with TRD.”

Reference

1. Vida RG, Sághy E, Bella R, et al. Efficacy of repetitive transcranial magnetic stimulation (rTMS) adjunctive therapy for major depressive disorder (MDD) after two antidepressant treatment failures: meta-analysis of randomized sham-controlled trials. BMC Psychiatry. 2023;23:545.