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Unipolar depression in adults: Indications, efficacy, and safety of transcranial magnetic stimulation (TMS)

Author
Paul E Holtzheimer, MD
Section Editor
Peter P Roy-Byrne, MD
Deputy Editor
David Solomon, MD

INTRODUCTION

Many patients with unipolar major depression do not respond to standard treatment with pharmacotherapy and psychotherapy [1,2] and are thus candidates for noninvasive neuromodulation procedures, including repetitive transcranial magnetic stimulation (TMS) and electroconvulsive therapy (ECT) [3-5]. Although ECT is more efficacious than repetitive TMS [6,7], patients may prefer repetitive TMS because it is better tolerated and unlike ECT, TMS does not require general anesthesia and induction of seizures.  

This topic reviews the indications, efficacy, and safety of TMS for treating unipolar major depression in adults; the technique for performing TMS is reviewed elsewhere. Other neuromodulation procedures, including ECT, magnetic seizure therapy, focal electrically administered seizure therapy, transcranial direct current stimulation, transcranial low voltage pulsed electromagnetic fields, cranial electrical stimulation, vagus nerve stimulation, deep brain stimulation, direct cortical stimulation, and ablative neurosurgery, are also discussed separately, as is choosing treatment for treatment resistant depression and treatment refractory depression:

(See "Technique for performing transcranial magnetic stimulation (TMS)".)

(See "Depression in adults: Overview of neuromodulation procedures".)

(See "Overview of electroconvulsive therapy (ECT) for adults".)

                        
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Literature review current through: Sep 2017. | This topic last updated: Sep 24, 2017.
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