The existing literature provides insufficient data to be able to decide whether there is a place for rTMS in the standard of care of depression. There are a lot of well-designed efficacy studies that compare the effect of rTMS on depression with sham-stimulation. However, they often use different stimulation parameters and localisation, which makes it difficult to draw an unequivocal conclusion. The studies usually have a short follow-up. Though favourable effects clearly do exist, there is no standard with regard to optimum technical application. Further systematic research will have to show whether rTMS deserves a place in depression treatment, whatis the best way to deliver it and for which categories of patients with depression there is a reasonable indication.
Currently the use of rTMS for depression does not comply with established medical science and medical practice.