Evidence-Based Reviews

Advances in transcranial magnetic stimulation for managing major depressive disorders

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References

The investigators concluded that MST might constitute an effective, well-tolerated, and safe treatment for patients unable to benefit from available medical therapies for depression. In addition to confirmation of acute benefit in more definitive trials, the issue of durability of effect needs further clarification.


TMS is a key component of neuropsychiatric practice
It has been 3 decades since Barker et al31 developed the technology to deliver intense, localized magnetic pulses to specific areas of the nervous system. During this period, the role of TMS as a probe of the central and peripheral nervous systems has expanded to include various therapeutic applications, primarily focusing on treatment-resistant major depressive disorder.

Now, increasing sophistication in the choice of stimulation parameters and other ongoing efforts to optimize the benefits of TMS are yielding improved clinical outcomes. Research is still needed to better define the place of TMS in the management of subtypes of depression that are particularly difficult to treat and that do not benefit adequately from medications or psychotherapy or their combination.

Growing support from controlled trials, systematic reviews, meta-analyses, naturalistic outcome studies, and professional guidelines indicate that TMS has an increasingly important role in clinical practice.


Bottom Line
Clinical use of transcranial magnetic stimulation (TMS) continues to expand, particularly for treatment-resistant depression. At the same time, ongoing research seeks to refine the application of TMS to enhance and expand its benefits.

Related Resources
  • www.Brainsway.com
  • www.Magstim.com
  • www.MagVenture.com

    Disclosures
    Dr. Janicak receives research support from Neuronetics, Inc; Sunovion Pharmaceuticals, Inc; and Ortho-McNeil-Janssen. He has served as a consultant to Neuronetics, Inc. Dr. Sackett, Ms. Kudrna, and Dr. Cutler report no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.

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