TY - JOUR
T1 - Revisiting the effectiveness of repetitive transcranial magnetic stimulation treatment in depression, again
AU - Fitzgerald, Paul B.
AU - Gill, Shane
AU - Breakspear, Michael
AU - Kulkarni, Jayashri
AU - Chen, Leo
AU - Pridmore, Saxby
AU - Purushothaman, Subramanian
AU - Galletly, Cherrie
AU - Clarke, Patrick
AU - Ng, Felicity
AU - Hussain, Salam
AU - Chamoli, Suneel
AU - Csizmadia, Tibi
AU - Tolan, Patrick
AU - Cocchi, Luca
AU - Ibrahim OAM, Samir
AU - Shankar, Kavitha
AU - Sarma, Shanthi
AU - Lau, Michael
AU - Loo, Colleen
AU - Yadav, Tarun
AU - Hoy, Kate E.
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: PBF is supported by an NHMRC Investigator Grant (1193596).
Publisher Copyright:
© The Royal Australian and New Zealand College of Psychiatrists 2021.
PY - 2022/8
Y1 - 2022/8
N2 - Following on from the publication of the Royal Australian and New Zealand Journal of Psychiatry Mood Disorder Clinical Practice Guidelines (2020) and criticisms of how these aberrantly addressed repetitive transcranial magnetic stimulation treatment of depression, questions have continued to be raised in the journal about this treatment by a small group of authors, whose views we contend do not reflect the broad acceptance of this treatment nationally and internationally. In fact, the evidence supporting the use of repetitive transcranial magnetic stimulation treatment in depression is unambiguous and substantial, consisting of an extensive series of clinical trials supported by multiple meta-analyses, network meta-analysis and umbrella reviews. Importantly, the use of repetitive transcranial magnetic stimulation treatment in depression has also been subject to a series of health economic analyses. These indicate that repetitive transcranial magnetic stimulation is a cost-effective therapy and have been used in some jurisdictions, including Australia, in support of public funding. An argument has been made that offering repetitive transcranial magnetic stimulation treatment may delay potentially effective pharmacotherapy. In fact, there is considerably greater danger of the opposite happening. Repetitive transcranial magnetic stimulation is as, if not more effective, than antidepressant medication after two unsuccessful medication trials and should be a consideration for all patients under these circumstances where available. There is no meaningful ongoing debate about the use of repetitive transcranial magnetic stimulation treatment in depression – it is a safe, effective and cost-effective treatment.
AB - Following on from the publication of the Royal Australian and New Zealand Journal of Psychiatry Mood Disorder Clinical Practice Guidelines (2020) and criticisms of how these aberrantly addressed repetitive transcranial magnetic stimulation treatment of depression, questions have continued to be raised in the journal about this treatment by a small group of authors, whose views we contend do not reflect the broad acceptance of this treatment nationally and internationally. In fact, the evidence supporting the use of repetitive transcranial magnetic stimulation treatment in depression is unambiguous and substantial, consisting of an extensive series of clinical trials supported by multiple meta-analyses, network meta-analysis and umbrella reviews. Importantly, the use of repetitive transcranial magnetic stimulation treatment in depression has also been subject to a series of health economic analyses. These indicate that repetitive transcranial magnetic stimulation is a cost-effective therapy and have been used in some jurisdictions, including Australia, in support of public funding. An argument has been made that offering repetitive transcranial magnetic stimulation treatment may delay potentially effective pharmacotherapy. In fact, there is considerably greater danger of the opposite happening. Repetitive transcranial magnetic stimulation is as, if not more effective, than antidepressant medication after two unsuccessful medication trials and should be a consideration for all patients under these circumstances where available. There is no meaningful ongoing debate about the use of repetitive transcranial magnetic stimulation treatment in depression – it is a safe, effective and cost-effective treatment.
KW - depression
KW - evidence
KW - guidelines
KW - mood disorders
KW - Repetitive transcranial magnetic stimulation
KW - response
UR - http://www.scopus.com/inward/record.url?scp=85122126891&partnerID=8YFLogxK
U2 - 10.1177/00048674211068788
DO - 10.1177/00048674211068788
M3 - Article
C2 - 34969310
AN - SCOPUS:85122126891
SN - 0004-8674
VL - 56
SP - 905
EP - 909
JO - Australian and New Zealand Journal of Psychiatry
JF - Australian and New Zealand Journal of Psychiatry
IS - 8
ER -