Assessing The Antidepressant Effect Of Two And Three Hf-Rtms Sessions Per Day

Background: Repetitive transcranial magnetic stimulation (rTMS) has proven antidepressant effects, but the optimal frequency of sessions remains unclear.Methods: We are in the process of conducting an open trial study to assess the antidepressant efficacy of twice or three times per day high frequency rTMS in patients with bipolar depression. Furthermore, a 3-week randomized controlled study was conducted to assess the antidepressant efficacy of one session/day compared to two active rTMS sessions/day and equivalent sham sessions in about 100 patients with unipolar major depression. High-frequency (20 Hz) rTMS was targeted to the left prefrontal cortex in sessions of approximately 40 trains (2 sec each) at 100 % resting motor threshold, with an inter-train interval of 1 min.Results: Results demonstrated superior antidepressant efficacy of two sessions of HF-rTMS per day compared to one session per day and to sham sessions for unipolar depression patients. Preliminary findings on bipolar depression patients show satisfactory efficacy of two or three HF-rTMs sessions per day.Conclusions: The application of two or three sessions of HF-rTMS per day may prove to be more beneficial for patients suffering from bipolar or unipolar depression compared to that of one daily session.