background Repetitive transcranial magnetic stimulation (rtms) has been found to be an effective technique in the treatment of unipolar depression. However, it is not yet clear whether rtms is also useful in the treatment of bipolar depression. aim To evaluate the available evidence that rtms is effective in the treatment of bipolar depression.

method Review of available literature (rcts and open-label studies). results We looked closely at four rcts and four open-label studies. In three of the four rcts the results for patients who had received rtms were no better than those for patients who had received a placebo. Patients in all four open-label studies showed significant improvement. One individual developed hypomanic symptoms. The studies used many different parameters; some studies included diagnoses, some referred to the type of medication used.

conclusion So far, there is a lack of high quality studies on which we can base our conclusions about the effectiveness of rtms for the treatment of bipolar depression. The use of rtms to treat patients with bipolar depression does not seem to increase the risk that a patient will develop (hypo)mania.