Although multiple psychotherapy and medication options exist for
treating major depression, they don't work for everyone. Patients
who have not responded to medication, or who have not been able to
tolerate other options, may be eligible for repetitive transcranial
magnetic stimulation (rTMS). The FDA in 2008 approved the first
repetitive rTMS device specifically for treating major depression
that has not responded to at least one medication taken at adequate
dose and duration (usually defined as at least four weeks). A
federally funded study provided further guidance about its use.
First, some caveats. Repetitive TMS is likely to be offered only
after several mainstream treatments for major depression have
already been tried; this method is not recommended for patients
with mild depression or newly diagnosed major depression. And rTMS
has not been studied in pregnant women or youths younger than 18.
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