The emerging role for repetitive transcranial magnetic stimulation in optimizing the treatment of adolescent depression.


Journal Article (Review)

Major depressive disorder (MDD) in adolescents is a common illness and significant public health problem. Treatment is challenging because of recurrences and limited modalities. Selective serotonin reuptake inhibitors and cognitive behavioral therapy are considered the standard of care in severe or treatment-resistant MDD in this age group. However, responses to these interventions are often suboptimal. A growing body of research supports the efficacy of repetitive transcranial magnetic stimulation (rTMS) for the treatment of MDD in adults. Induced seizures are a primary safety concern, although this is rare with appropriate precautions. There is, however, limited experience with rTMS as a therapeutic intervention for adolescent psychiatric disturbances. This review will summarize the rTMS efficacy and safety data in adults and describe all published experience with adolescent MDD. Applications in other adolescent psychiatric illnesses such as schizophrenia and attention-deficit/hyperactivity disorder are reviewed. Safety and ethical issues are paramount with investigational treatments in adolescent psychiatric illnesses. However, further research with rTMS in adolescent MDD is imperative to establish standards for optimal stimulation site, treatment parameters, and its role in treatment algorithms. These may diverge from adult data. Early intervention with neuromodulation could also hold the promise of addressing the developmental course of dysfunctional neurocircuitry.

Full Text

Duke Authors

Cited Authors

  • Croarkin, PE; Wall, CA; McClintock, SM; Kozel, FA; Husain, MM; Sampson, SM

Published Date

  • December 2010

Published In

Volume / Issue

  • 26 / 4

Start / End Page

  • 323 - 329

PubMed ID

  • 20418774

Pubmed Central ID

  • 20418774

Electronic International Standard Serial Number (EISSN)

  • 1533-4112

Digital Object Identifier (DOI)

  • 10.1097/YCT.0b013e3181dd17eb


  • eng

Conference Location

  • United States