Accelerated transcranial magnetic stimulation for the treatment of Patients with depression: A review

Major depressive disorder is a highly prevalent and profoundly disabling psychiatric disorder with significant morbidity and mortality and it is very often resistant to antidepressants, electroconvulsive therapy and psychotherapy. Therapeutic alternatives include repetitive transcranial magnetic stimulation which may be an effective choice for treatment-resistant depression but requires prolonged treatments for at least four to six weeks. Shorter exposure to this technique might be more advantageous for certain cases. The purpose of this review is to describe and discuss studies that have evaluated the safety and efficacy of accelerated transcranial magnetic stimulation (aTMS) in the acute treatment of depression. Methods: The electronic literature (NCBI Pubmed; Science Direct) on aTMS for the treatment of depression was reviewed. In the last years, a limited number of controlled and open-label studies have been published on the subject. The majority of these studies have shown promising results with aTMS, this protocol probably being at least as safe and as efficacious as conventional rTMS (five sessions per week) in the treatment of treatment-resistant depression (TRD) with a trend for faster response rates when more intensive protocols are used (15 sessions over two days). Future well-designed sham-controlled studies with larger samples are needed to confirm the safety and efficacy of aTMS in the treatment of depression.