The clinical introduction of rTMS for the treatment of depression is now progressing in Japan. On the basis of the successful results of a large-scale RCT, the US FDA approved an rTMS device in 2008, and four rTMS devices are now approved and used in several countries and the EC. The results of the meta-analysis of RCTs and the real-world naturalistic observational studies show beneficial effects on treatment-resistant depression. The rTMS is generally well-tolerated and safe, but has a risk of seizure, with an estimated rate of approximately one in 1,000 patients. The rTMS is thought to be an effective treatment for those unable to benefit from initial antidepressant medication.
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