A review of the safety of repetitive transcranial magnetic stimulation as a clinical treatment for depression.
There is growing interest worldwide in rTMS as a clinical treatment for depression. Apart from efficacy, its safety as a clinical treatment must be considered before its widespread use can be advocated. All published, sham-controlled rTMS depression trials were reviewed for reported side-effects and outcomes of formal neuropsychological testing. In addition, all reports of seizures occurring with rTMS were reviewed. Other safety concerns (effects on hearing; headache, pain, induced currents in electrical circuits, histotoxicity, electromagnetic field exposure, psychiatric complications, safety in pregnancy) are discussed. Common side-effects were of a minor nature, e.g. headache. There was a low incidence of accidental seizures and induced hypomania, both of which were associated with identified risk factors for which subjects should be screened. Long-term effects of repeated rTMS sessions are as yet unknown. When given within recommended guidelines, the overall safety profile of rTMS is good, and supports its further development as a clinical treatment.
Loo
Colleen K
CK
School of Psychiatry, University of New South Wales, Sydney, Australia. colleen.loo@unsw.edu.au
McFarquhar
Tara F
TF
Mitchell
Philip B
PB
D000328:Adult; D003863:Depression / Q000150:complications* / Q000628:therapy*; D005260:Female; D006261:Headache / Q000209:etiology; D006309:Hearing / Q000502:physiology; D006801:Humans; D001523:Mental Disorders / Q000209:etiology; D009483:Neuropsychological Tests; D011247:Pregnancy; D012640:Seizures / Q000453:epidemiology / Q000209:etiology; D050781:Transcranial Magnetic Stimulation / Q000009:adverse effects* / Q000523:psychology