Abstract

Background Current medication and transcranial magnetic stimulation (TMS) treatments for depression bring only approximately one-third of patients to remission. Newer TMS techniques such as bilateral treatment, neuronavigation, and theta burst stimulation (TBS) show promise in improving remission rates. However, it is unclear whether newer off-label techniques improve outcomes enough to justify widespread implementation.

Methods An IRB approved retrospective chart review examined 58 primarily treatment-resistant (79%) depressed patients who received bilateral neuronavigated TBS-20Hz in a private outpatient clinic.

Results 72% (42/58) of patients remitted (Beck Depression Inventory-II (BDI-II) < 13) with an 81% decrease in BDI-II scores. 83% (48/58) of patients responded (BDI-II ≤ 50%). Average time to remission was 7.3 treatment weeks (SD = 4.5, Range 0.6–21.2). Overall, 40% (17/42) of remitters also successfully discontinued one or more pretreatment medications.