2016 Volume 28 Issue 2 Pages 132-146
In this article, I aim to outline the present state and findings on the clinical efficacy and safety of repetitive transcranial magnetic stimulation (rTMS) and magnetic seizure therapy (MST). In addition, I introduce foreign guidelines for the treatment of patients with major depressive disorder and treatment-resistant depression (TRD). Although rTMS treatment for TRD in the acute phase is not usually superior to electroconvulsive therapy (ECT) in terms of its antidepressant effect, it is suggested that rTMS has an effect comparable to that of ECT in relapse prevention during the continuation and/or maintenance phase of treatment. On the other hand, MST has characteristics comparable to those of ECT even in the acute phase of treatment and results in faster recovery of orientation after treatment. Furthermore, it is assumed that rTMS and MST have no specific “social stigma”, or the adverse cognitive effect that ECT usually has. It is also estimated that the cost-effectiveness of rTMS is almost equivalent to that of ECT. Moreover, neurostimulation therapy has the potential to reduce the adverse effects of medication as well as overall healthcare costs in the long term. For optimization of treatment parameters and protocols, further research is needed for a more detailed understanding of the therapeutic mechanism of the neurostimulation represented by rTMS. In the future, through such efforts, it would be possible to implement personalized neurostimulation therapy tailored to the condition of the individual patient with TRD.
