“TMS is an effective treatment for those unable to benefit from initial antidepressant medication”
Modern TMS treatment for depression has been studied for over 20 years, with many of the studies being conducted in Australia. The Royal Australian New Zealand College of Psychiatrists states that “there is a good evidence base for the therapeutic efficacy of rTMS in major depressive disorder. Those with treatment resistant depression who respond to rTMS treatment (approximately 50% of patients) will subsequently experience a lower burden of disease” (RANZCP 2019). Multiple studies and treatment evidence were presented to Medicare to have it reimbursed.
A comparison of 29 double blind and sham controlled studies with 1371 patients indicated that “seems to be associated with clinically relevant antidepressant effects and with a benign tolerability profile” and that the treatment is effective beyond placebo (Berlim 2013).
Double blinded placebo-controlled studies are a “gold standard” type of study where patients are split into groups with one group receiving live TMS treatment, the other group receives sham treatment, which is usually a TMS machine that is made to look and feel like TMS treatment but is not live or else putting the magnet in the wrong spot for depression. For double blinded studies the researcher and patient do not know if the patient is in the sham or live treatment. This is to remove the placebo effect from treatment.”
Naturalistic studies (treatment where patients know they are having treatment) have the highest outcomes as they represent real world outcomes of TMS. A well-known naturalistic study demonstrates that “TMS is an effective treatment for those unable to benefit from initial antidepressant medication” and details a 58% response rate (~3 in 5 people have a reduction in symptoms) and a 37.1% remission, meaning 2 in 5 patients were no longer depressed after treatment (Carpenter 2012).
Because TMS treatment does not have the financial backing of the pharmaceutical companies, many of the studies have been conducted by passionate, individual researchers.