Consensus Recommendations for the Clinical Application of Repetitive Transcranial Magnetic Stimulation (rTMS) in the Treatment of Depression

• DOI: 10.4088/jcp.16cs10905
• Publication Date: 2017-05-22T20:19:06Z
• Authors: Shawn M. McClintock; Irving M. Reti; Linda L. Carpenter; William M. McDonald; Marc Dubin; Stephan F. Taylor; Ian A. Cook; John O’Reardon; Mustafa M. Husain; Christopher Wall; Andrew D. Krystal; Shirlene M. Sampson; Oscar Morales; Brent G. Nelson; Vassilios Latouss...; Mark S. George; Sarah H. Lisanby
• Keywords: Consensus; Major Depressive Disorder; Clinical Sciences; Clinical Trials and Supportive Activities; 610; Clinical sciences; Medical and Health Sciences; 03 medical and health sciences; 0302 clinical medicine; Clinical Research; Humans; National Network of Depression Centers rTMS Task Group; Psychiatry; Depressive Disorder; Biomedical and Clinical Sciences; Depression; Contraindications; Psychology and Cognitive Sciences; Major; Serious Mental Illness; Mental Illness; Transcranial Magnetic Stimulation; Brain Disorders; 3. Good health; Psychiatry and Mental health; Mental Health; American Psychiatric Association Council on Research Task Force on Novel Biomarkers and Treatments; Mental health

Objective To provide expert recommendations for the safe and effective application of repetitive transcranial magnetic stimulation (rTMS) in the treatment of major depressive disorder (MDD). Participants Participants included a group of 17 expert clinicians and researchers with expertise in the clinical application of rTMS, representing both the National Network of Depression Centers (NNDC) rTMS Task Group and the American Psychiatric Association Council on Research (APA CoR) Task Force on Novel Biomarkers and Treatments. Evidence The consensus statement is based on a review of extensive literature from 2 databases (OvidSP MEDLINE and PsycINFO) searched from 1990 through 2016. The search terms included variants of major depressive disorder and transcranial magnetic stimulation. The results were limited to articles written in English that focused on adult populations. Of the approximately 1,500 retrieved studies, a total of 118 publications were included in the consensus statement and were supplemented with expert opinion to achieve consensus recommendations on key issues surrounding the administration of rTMS for MDD in clinical practice settings. Consensus process In cases in which the research evidence was equivocal or unclear, a consensus decision on how rTMS should be administered was reached by the authors of this article and is denoted in the article as "expert opinion." Conclusions Multiple randomized controlled trials and published literature have supported the safety and efficacy of rTMS antidepressant therapy. These consensus recommendations, developed by the NNDC rTMS Task Group and APA CoR Task Force on Novel Biomarkers and Treatments, provide comprehensive information for the safe and effective clinical application of rTMS in the treatment of MDD.