The defining qualities of rTMS treatment make it a potential first-line treatment when pharmacotherapy has failed or is not an option: it is safe and tolerable, leads to minimal side effects, is easily delivered in an outpatient setting, and, while less efficacious than ECT, demonstrates real world response and remission rates conservatively estimated as approximately 60% and 30%, respectively. Additionally, a network meta-analysis revealed superior remission rates for rTMS compared to standard pharmacologic strategies at 4–6 week outcomes. The use of rTMS as a treatment for TRD is growing in acceptability, and future advances in the field are poised to broaden and enhance its role in treating MDD and other neuropsychiatric conditions.
