Treatment of major depressive disorder (MDD) can include a variety of biopsychosocial approaches. In medical practice, antidepressant drugs are the most common treatment for moderate to severe depressive episodes; however, their efficacy is limited. Many depressed patients are considered treatment-resistant, with 33% ssion after ≥3 treatment trials. A systemic review and meta-analysis revealed that repetitive transcranial magnetic stimulation (rTMS) may be reasonably considered for patients with MDD and ≥2 prior failures of antidepressant treatment. No rTMS devices have been approved by the Japanese Pharmaceuticals and Medical Devices Agency, which has resulted in its off-label use; therefore, to offer better care for cases of treatment-resistant MDD, we should continue efforts to seek the introduction of rTMS to Japan.
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