Changes in the Use of Repetitive Transcranial Magnetic Stimulation Therapy Between 2016 and 2022 in Northern Finland

Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for depression. However, knowledge of changes in treatment numbers and the proportion of acute versus maintenance rTMS is lacking. This study aimed to examine the number of rTMS treatments, rates of return for additional treatment, and factors associated with these patterns in Northern Finland from 2016 to 2022.

Data were collected from the electronic patient registry of the Oulu University Hospital neuromodulation unit. We analyzed the number of treatment sessions given annually, the number of patients treated and retreated, and whether the main diagnosis, age, or gender were associated with retreatment.

The annual number of rTMS treatment sessions increased from 549 to 2884, with a 3-fold increase in acute and a 35-fold increase in maintenance treatments. There was a 3-fold increase in patients receiving acute and a 16-fold increase in patients receiving maintenance treatments. A total of 64% were females. The most common diagnosis was recurrent depressive episode (49%). The rTMS rate was 9.5 per 100,000 in 2017 and 24 per 100,000 in 2022. In all, 23% of patients returned to acute or maintenance treatment. Female gender and recurrent depressive disorder were associated with retreatment.

rTMS use increased substantially, especially in maintenance sessions, with rising retreatment rates. While access improved, demand for maintenance care is straining capacity and prolonging waiting for acute treatment. Additional resources and research on optimal treatment schedules, relapse prevention, and cost‑effectiveness are needed.