Review: repetitive transcranial magnetic stimulation has antidepressant effects.

Data extraction Data were extracted on diagnostic criteria, presence or absence of antidepressant medication, method of randomisation and study design features, outcome measurement, blinding, and adverse effects. Main results 5 trials were included (151 patients). All trials included patients who met DSM-III-R or DSM-IV criteria for a major depressive episode. In all 5 trials, placebo treatment consisted of placing the TMS coil at an ineffective angle of 45° or 90° to the scalp. All trials had blinded outcome assessments using the Hamilton Depression Rating Scale; 2 studies also used the Beck Questionnaire and 2 others also used the MontgomeryÅsberg Depression Rating Scale. More improvement in depression occurred in patients who received rTMS than in those who received placebo (p < 0.001) (table). No patients withdrew from treatment because of adverse effects. 1 additional trial was identified of rTMS in the treatment of schizophrenia and showed no beneficial effects of rTMS.