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.