Background: Multiple studies have reported positive statistical results for repetitive transcranial magnetic stimulation (rTMS) (compared to a sham control) in treating depression, but the results of many studies were not clinically impressive. Recent studies have explored strategies to optimise the efficacy of rTMS.
Aims: To review strategies to improve the antidepressant efficacy of rTMS
Methods: Sham-controlled studies undertaken by the TMS research group at the University of NSW to explore and improve the efficacy of rTMS include high frequency left prefrontal stimulation, bilateral prefrontal stimulation and twice-daily treatments. The design and results of these studies will be presented.
Results: There is evidence for the efficacy of high frequency left prefrontal rTMS in treating depression and twice-daily sessions may further enhance results. Bilateral high frequency rTMS was not effective.
Conclusions: Further strategies to enhance the efficacy of rTMS should be explored – future directions will be discussed.
