Advances in repetitive transcranial magnetic stimulation in the treatment of treatment-resistant depression: a comprehensive review

Abstract Major depressive disorder is a common mental disorder, and a significant number of patients exhibit poor response to conventional antidepressant treatments, known as treatment-resistant depression (TRD). However, the definition of TRD globally remains unclear, impeding clinical research, treatment development, outcome implementation, and policy-making. A wealth of research confirms that rTMS demonstrates promising efficacy in TRD. This paper elucidates the definition of TRD, summarizes potential targets of rTMS for treating TRD, comprehensively elaborates on the unique mechanisms, efficacy, and side effects of rTMS in treating TRD, and outlines considerations for special populations receiving rTMS treatment for TRD as well as other treatment modalities for TRD. Through these studies, we aim to provide more scientifically grounded recommendations for patients undergoing rTMS treatment for TRD.