SynthesisBMC psychiatry2023
Efficacy of repetitive transcranial magnetic stimulation (rTMS) adjunctive therapy for major depressive disorder (MDD) after two antidepressant treatment failures: meta-analysis of randomized sham-controlled trials.
Synthesis in BMC psychiatry, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 5 syntheses or guidelines pooled it, 80 citations in OpenAlex.
- Ultrasound Applications in the Treatment of Major Depressive Disorder: A Systematic Review of Techniques and Therapeutic Potentials in Clinical Trials and Animal Model Studies.Neuromodulation : journal of the International Neuromodulation Society · 2026Pooled it
- Ultrabrief pulse electroconvulsive therapy for depression: a systematic review and meta-analysis.Molecular psychiatry · 2026Pooled it
- Depressive disorders: systematic review of approved psychiatric medications (2009-April 2025) and pipeline phase 3 medications.BMC psychiatry · 2025Pooled it
- A meta-analysis of transcranial magnetic stimulation in Tourette syndrome.Journal of psychiatric research · 2024Pooled it
- Inappropriate study inclusion in meta-analysis of sham-controlled rTMS for treatment-resistant depression.BMC psychiatry · 2024Pooled it
- Repetitive Transcranial Magnetic Stimulation as Maintenance Treatment of Depression: The MAINT-R Randomized Clinical Trial.JAMA network open · 2025Trial
- Effect of DLPFC rTMS on anhedonia and alpha asymmetry in depressed patients.Scientific reports · 2025Trial
- Neurostimulation in the treatment of psychiatric disorders: Underlying mechanisms and critical analysis of circuit-based interventions.Molecular psychiatry · 2026Review
- Reward pursuit during a translational reward task correlates with anhedonia reductions following rTMS in patients with major depressive disorder.Translational psychiatry · 2026Article
- Patient perspectives on barriers to rTMS for peripartum depression.BMC psychiatry · 2026Article
- Measuring and appraising placebo effects in clinical trials: contemporary challenges and approaches in psychiatry.The lancet. Psychiatry · 2026Review
- Review
- Factors That Influence Patients' Decisions About Repetitive Transcranial Magnetic Stimulation as a Treatment Option for Treatment-Resistant Depression: Protocol for a Prospective Mixed Methods Cohort Study.JMIR research protocols · 2026Article
- The Role of Adverse Childhood Experiences in the Development of Major Depressive Disorder and Treatment-Resistant Depression.Child psychiatry and human development · 2026Review
- Combining Noninvasive Brain Stimulation and Physiotherapy to Improve the Management of Chronic Low Back Pain in Veterans: Protocol for a Multi-Arm Randomized Controlled Trial.JMIR research protocols · 2026Article
- Feasibility of Integrating Real-Time fMRI Neurofeedback with rTMS: Study Design, Preliminary Results, and Technical Challenges.Aperture neuro · 2026Article
- From lobotomy to connectomics: a critical review of contemporary psychosurgery.Frontiers in psychiatry · 2026Review
- Noninvasive profiling of input-output excitability curves in human prefrontal cortex.bioRxiv : the preprint server for biology · 2025Article
- Epigenetic profiles of response to transcranial magnetic stimulation in treatment resistant depression.BMC medical genomics · 2025Article
- Accelerated left dorsolateral prefrontal cortex transcranial magnetic stimulation for suicidality in patients with depressive disorders: A case series.Indian journal of psychiatry · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeveral meta-analyses demonstrated the efficacy of unilateral High-Frequency Left-sided (HFL) repetitive Transcranial Magnetic Stimulation (rTMS) for individuals with Major Depressive Disorder (MDD); however, results are contradictory due to heterogeneity of the included studies.
methodsA systematic literature review (SLR) of English language articles published since 2000 was performed in March 2022 on PubMed and Scopus databases. Empirical evidence on the relative efficacy of rTMS treatment compared with standard pharmacotherapy in Treatment-Resistant Depression (TRD) were extracted. Random effects models were used to assess the effects of rTMS on response and remission rates.
results19 randomized double-blinded sham-controlled studies were included for quantitative analysis for response (n = 854 patients) and 9 studies for remission (n = 551 patients). The risk ratio (RR) for response and remission are 2.25 and 2.78, respectively for patients after two treatment failures using rTMS as add-on treatment compared to standard pharmacotherapy. Cochrane's Q test showed no significant heterogeneity. No publication bias was detected.
conclusionsrTMS is significantly more effective than sham rTMS in TRD in response and remission outcomes and may be beneficial as an adjunctive treatment in patients with MDD after two treatment failures. This finding is consistent with previous meta-analyses; however, the effect size was smaller than in the formerly published literature.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.