rTMS for depression: The difficult transition from research to clinical practice

The publication of the 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of mood disorders was followed by a series of correspondences discussing the place of repetitive transcranial magnetic stimulation (rTMS) in the sequence care for the routine treatment of depression. The controversy has led to an intense debate about the positioning of this neuromodulation technique in the clinical armamentarium for depression in the Australian and New Zealand Journal of Psychiatry. The many arguments presented by the authors to defend their respective points of view can be summarised in two main key issues: (i) the interpretation of the level of evidence of rTMS for depression and (ii) the characterisation of patients who could benefit from this treatment. In this viewpoint, we discuss the difficult transition from research to clinical practice regarding the use of rTMS to treat depression.