Underpowered Repetitive Transcranial Magnetic Stimulation Might Not Be an Effective Antidepressant Treatment

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Sir: Koerselman et al.1 reported the results of a trial of repetitive transcranial magnetic stimulation (rTMS) for the treatment of depressive disorders. After 2 weeks, the improvement on the 17-item Hamilton Rating Scale for Depression (HAM-D) was not different between the active and the placebo arms of the study and in fact was very disappointing at 18.5% and 15.4%, respectively.

We agree with the authors that one explanation for the poor outcome was the low setting of the stimulation parameters, especially the use of just 80% of motor threshold.​

J Clin Psychiatry 2005;66(4):543-543