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 repetitivetranscranial magnetic stimulation (rTMS) for the treatmentof depressive disorders. After 2 weeks, the improvementon the 17-item Hamilton Rating Scale for Depression (HAM-D)was not different between the active and the placebo arms of thestudy and in fact was very disappointing at 18.5% and 15.4%,respectively.

We agree with the authors that one explanation for the pooroutcome was the low setting of the stimulation parameters, especiallythe use of just 80% of motor threshold.’ ‹