Major depressive disorder is one of the most common mental disorders in the general and Veteran populations. The one-to two-thirds of MDD patients who do not respond to the first antidepressant prescribed, and the 15% to 33% who do not respond to multiple drugs are defined as having treatment-resistant depression (TRD). Repetitive transcranial magnetic stimulation
(rTMS) is one of many possible options for treating TRD. It is supported by two FDA-cleared protocols and acceptable acute efficacy based on a recent Comparative Effectiveness Review conducted by the RTI-UNC EPC. This Evidence Brief synthesizes the literature on factors that optimize rTMS therapy in patients with TRD.
Key Question #1:
Which patients have the best chance of success with rTMS?
Key Question #2:
What are the optimal rTMS treatment protocols and parameters?
Key Question #3:
What is known about the continuation and maintenance treatment in