Background report on assessing established medical science and medical practice in repetitive transcranial magnetic stimulation (rTMS) in depression

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.