title: Is it time to introduce repetitive transcranial magnetic stimulation into standard clinical practice for the treatment of depressive disorders?
abstract: OBJECTIVE
  To examine issues relating to the potential introduction of repetitive transcranial magnetic stimulation (rTMS) into clinical practice as a treatment for depression.
  
  
  METHODS
  A review of the outcomes literature accompanied by an analysis of issues relating to the potential advantages and pitfalls of the introduction of rTMS as a treatment strategy.
  
  
  RESULTS
  Evidence is progressively accumulating that rTMS has antidepressant properties that are clinically relevant. These effects are biologically plausible and supported by basic research. Patients with therapy-resistant depression have few treatment alternatives and experience significant suffering, thus justifying the early introduction of a new treatment such as rTMS for this patient group. However, this must be balanced by a need to foster considerable further research and not to raise expectations unreasonably.
  
  
  CONCLUSIONS
  It is timely for rTMS to be made more available to patients with treatment-resistant mood disorders. This need not be limited to clinical research trials but should only occur in medical settings where continual evaluation and research is conducted.
authors.affiliation: Alfred Psychiatry Research Centre, The Alfred and Monash University Department of Psychological Medicine, Prahan, Victoria, Australia. paul.fitzgerald@med.monash.edu.au
authors.forename: Paul
authors.initials: P
authors.lastname: Fitzgerald
mesh_terms: D000293:Adolescent; D000328:Adult; D003866:Depressive Disorder / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000295:instrumentation*; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000503:physiopathology; D012886:Skull; D050781:Transcranial Magnetic Stimulation / Q000009:adverse effects* / Q000295:instrumentation*