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Research into the efficacy of repetitive transcranial magnetic stimulation (rTMS) in depression has produced variable results and prompted questions about the adequacy of the sham control. In this NIH-sponsored study, researchers randomized 190 antidepressant-free patients with unipolar nonpsychotic major depression to sham or active, moderately fast, left prefrontal rTMS (10 Hz). Patients had failed an average of 1.5 antidepressant trials for the current episode and 3.3 antidepressant trials in their lifetimes.
Patients were treated weekdays (37.5 minutes/session) for 3 weeks. Then, remitters began antidepressant medication, improvers (≥30% improvement in Hamilton Rating Scale for Depression [HRSD] score) continued their assigned treatments…