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J Clin Psychiatry. 2018 Jan/Feb;79(1). pii: 16cs10905. doi: 10.4088/JCP.16cs10905.

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

Author information

1
Department of Psychiatry, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-8898. shawn.mcclintock@utsouthwestern.edu.
2
Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas, USA.
3
Division of Brain Stimulation and Neurophysiology, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA.
4
Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
5
Butler Hospital, Brown Department of Psychiatry and Human Behavior, Providence, Rhode Island, USA.
6
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA.
7
Department of Psychiatry, Weill Cornell Medical College, White Plains, New York, USA.
8
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.
9
Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Behavioral Sciences and of Bioengineering, University of California at Los Angeles, Los Angeles, California, USA.
10
Department of Psychiatry and Behavioral Sciences, Rowan University School of Medicine, Stratford, New Jersey, USA.
11
PrarieCare, Rochester, Minnesota, USA.
12
Department of Psychiatry, University of California San Francisco School of Medicine, San Francisco, California, USA.
13
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA.
14
Psychiatric Neurotherapeutics Program, McLean Hospital, Harvard Medical School, Boston, Massachusetts, USA.
15
Department of Psychiatry, University of Minnesota, St Louis Park, Minnesota, USA.
16
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.
17
Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA.

Abstract

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.

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