Transcranial magnetic stimulation significantly reduces acute symptoms of major depression and offers an alternative to conventional therapy, investigators in a multicenter trial have concluded.

Patients treated with transcranial magnetic stimulation had almost a twofold higher remission rate at six weeks compared with patients who received sham therapy in the randomized study, John P. O'Reardon, M.D., of the University of Pennsylvania, and colleagues reported in the Dec. 1 issue of Biological Psychiatry.

Their finding offers a ray of hope to the 20 to 40 percent of patients who do not respond to antidepressants and psychotherapy and to those who do not wish to treat their illness with drugs.

"This study provides new support for the efficacy of TMS (transcranial magnetic stimulation) as a 'stand alone' treatment for depression," said John Krystal, editor of Biological Psychiatry.

The treatment works by sending very rapid bursts of magnetic energy into the brain through coils attached to the scalp.

These pulses cause the neurons in a small area of the brain to "fire off," said study co-author Philip Janicak, a psychiatry professor at Rush University Medical Center in Chicago.

Transcranial magnetic stimulation has been used as an alternative to electroshock treatment since the mid 1980's but small-scale studies of its effectiveness have shown mixed results, Janicak said.

This is the first large-scale study of the technique and researchers also used much higher doses of the energy pulses.

Researchers in at 23 sites in Canada, the United States and Australian randomly assigned 325 patients suffering from major depressive disorder to nine weeks of magnetic stimulation or a sham treatment.

Neither the patients nor the researchers knew who received the sham treatments and there was a very low drop-out rate, indicating that the treatment was well-tolerated by patients.

Side effects included headaches and scalp discomfort, researchers said.

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