Rapid relief of suicidal ideation via repetitive transcranial magnetic stimulation (rTMS) in depressed patients

Repetitive transcranial magnetic stimulation (rTMS) is an established neuromodulation technique for treatment-resistant depression. This study evaluated the efficacy of rTMS in reducing suicidal ideation (SI) in patients with depression and anxiety, and identified clinical variables predictive of treatment response.

This retrospective cohort study included 104 adults (aged 38-61) with SI treated at two psychiatric clinics in Spain (2022-2024). Patients underwent 30 sessions of bilateral rTMS targeting the dorsolateral prefrontal cortex (DLPFC). Clinical outcomes were measured using the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Scale (HAS). SI was assessed using item 3 of the HDRS, with scores ≥ 3 indicating active SI.

Significant reductions were observed in depressive symptoms, anxiety, and SI (all p < 0.001). Remission was achieved in 41 % for depression (HDRS ≤ 7), 33 % for anxiety (HAS ≤ 10), and 61 % for SI (HDRS item 3 = 0). Patients with lower baseline anxiety levels showed greater SI reduction. Both active and passive SI groups improved significantly.

Bilateral rTMS effectively reduced SI and associated symptoms in a clinically diverse population.

rTMS is a promising, noninvasive intervention for rapidly alleviating suicidal ideation in patients with depression and comorbid anxiety, particularly those with milder anxiety symptoms.