Key result
Accelerated iTBS achieves ~50% remission vs sham in treatment-resistant depression within five days.
Why the study?
Although rTMS is an effective intervention for treatment-resistant depression, its standard delivery schedule is time intensive and clinical response typically occurs gradually.
Do accelerated repetitive transcranial magnetic stimulation (rTMS) and intermittent Theta Burst Stimulation (iTBS) protocols improve clinical response in patients with treatment-resistant depression?
Do accelerated repetitive transcranial magnetic stimulation (rTMS) and intermittent Theta Burst Stimulation (iTBS) protocols improve clinical response in patients with treatment-resistant depression?
Effect estimate: null
Absolute Event Rate: 50% vs 21%
Accelerated rTMS and iTBS protocols represent a time-efficient and clinically effective intervention for treatment-resistant depression, with particular promise for patients requiring rapid response such as those with acute suicidal ideation.
May accelerate remission in TRD; leaves open durability, scalability, and need for confirmatory RCTs.
Major depressive disorder (MDD) is a severe and commonly occurring psychiatric illness with a substantial proportion of patients failing to respond adequately to standard treatments, often referred to as treatment-resistant depression (TRD). Repetitive transcranial magnetic stimulation (rTMS) has been developed as a safe and clinically effective intervention for TRD and is now increasingly accessible in routine clinical settings [1]. Although rTMS produces meaningful antidepressant effects for many patients, the standard delivery schedule is time intensive and clinical response typically occurs gradually.
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Fitzgerald et al. (2026) conducted a review in treatment-resistant depression. accelerated intermittent theta burst stimulation (iTBS) vs. standard rTMS or sham was evaluated on antidepressant response/remission rates (null). Accelerated iTBS protocols, such as the Stanford Neuromodulation Therapy (SNT), achieved remission rates up to 50% compared to 21% with sham in treatment-resistant depression within 5 days.
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