NeuroStar® TMS Therapy
FDA-cleared, non-medication depression treatment
(855) 940-4867
Medically reviewed on by
Steven Harvey, MD
Regional Medical Director Missouri
*Please note that this blog references real studies around treatment-resistant depression and TMS therapy and is written by a medical professional. Please consult your own care team or contact Greenbrook TMS to discuss options that are best suited for your personal situation.
When antidepressant medications don't seem to work, we call it treatment-resistant depression, or TRD. Individuals with TRD typically try many medications and other treatments, such as talk therapy, without experiencing significant relief from their symptoms. Luckily, medication is not the only option. TMS is a different kind of treatment that often works when medication has failed. Psychiatrists and other mental health providers have long known that TMS often works for patients who don’t get better with medications. But now, there is some fresh evidence of how much better TMS is.
In the past, we had studies of antidepressant medications and other studies of TMS. We never had a good study that directly compared the two head-to-head
in the same study. But, now we do.
In a recently published study (Dalhuisen et al., Am J Psych, 2024), patients with major depressive disorder and two failed medication trials were randomized to open-label treatment with either TMS or a switch to another antidepressant medication. HAM-D scores, rates of response, and rates of remission evaluated treatment outcomes. We define response as at least a 50% reduction in depressive symptoms and remission as almost complete relief from depressive symptoms.
TMS won by a wide margin. The response rate was 37.5% in the TMS group and only 14.6% in the medication group. The remission rate was 27.1% in the TMS group and a dismal 4.9% in the medication group.
As an important aside, it is interesting that the study’s 37.5% response rate in the TMS group is lower than what we’re accustomed to seeing. This might be because patients in this study had only 25 treatment sessions, instead of the more normal course of 30-36 TMS treatments. In my opinion, it is safe to assume that the advantage of TMS over medication would have been even larger if the TMS subjects had gotten a full course of 36 treatments.
The bottom line is that this study gives the world a considerably higher quality of evidence for something we already know: for treatment-resistant depression, TMS is a lot more effective than trying another medication.
**rTMS as a Next Step in Antidepressant Nonresponders: A Randomized Comparison With Current Antidepressant Treatment Approaches” https://psychiatryonline.org/doi/10.1176/appi.ajp.20230556
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