---
title: Even more evidence of the value of TMS Therapy
description: Discover why antidepressants may not be as effective as expected and explore alternative treatments like transcranial magnetic stimulation (TMS) for depression.
---

[Mental Health Resources ](https://www.mmhg.com.au/blog)

# [Even more evidence of the value of TMS Therapy](https://www.mmhg.com.au/blog/more-evidence-of-value-tms-therapy)

 Written by [TMS Australia](https://www.mmhg.com.au/blog/author/admin) | Apr 16, 2024 1:30:37 AM

## **Introduction to TMS Therapy**

New data has recently been published providing compelling evidence that clinicians should consider [repetitive transcranial magnetic stimulation (TMS)](https://www.mmhg.com.au/services/tms) much earlier for patients who do not respond to antidepressant medication. The study focused on 278 individuals with [treatment-resistant depression](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6982454/), defined as depression unresponsive to at least two antidepressant medications during their current [depressive episode](https://www.mmhg.com.au/conditions/depression).

## **Study Design and Treatment Options**

Participants were randomly assigned to one of three treatment strategies: 1) switching to the antidepressant [venlafaxine XR](https://pubmed.ncbi.nlm.nih.gov/19667502/) (or [duloxetine ](https://www.ncbi.nlm.nih.gov/books/NBK549806/#:~:text=Duloxetine%20is%20a%20medication%20used,neuropathy%20and%20stress%20urinary%20incontinence.)if more suitable), 2) adding the atypical antipsychotic medication [aripiprazole](https://www.ncbi.nlm.nih.gov/books/NBK547739/#:~:text=Aripiprazole%20is%20a%20medication%20used,depressive%20disorder%2C%20and%20Tourette%20syndrome.), or 3) beginning [TMS therapy](https://www.mmhg.com.au/services/tms). The [Montgomery-Asberg Depression Rating Scale (MADRS)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6878407/) was employed to measure outcomes, a standard metric for evaluating the efficacy of antidepressant treatments. Both medication doses and TMS application (delivered via 10Hz pulses to the left frontal cortex) followed standard protocols.

## **Comparative Results and Efficacy**

In primary assessments, TMS significantly outperformed [venlafaxine XR](https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Venlafaxine-(Effexor)) in improving MADRS scores. Response rates were notably higher with TMS (52.2%) compared to [venlafaxine XR](https://www.ncbi.nlm.nih.gov/books/NBK535363/) (35.8%) and [aripiprazole](https://www.webmd.com/drugs/2/drug-64437-4274/aripiprazole-oral/aripiprazole-oral/details) (38.1%). While these figures were not statistically compared across all three groups simultaneously, the trend favors TMS.

## **Safety and Tolerability**

Regarding safety, TMS exhibited a lower incidence of adverse events (39.3%) compared to [venlafaxine XR](https://www.webmd.com/drugs/2/drug-4896/effexor-xr-oral/details) (49.5%) and [aripiprazole](https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Aripiprazole-(Abilify)) (57%). This finding supports earlier studies suggesting that TMS is not only effective but also generally well-tolerated and safer than other treatment options.

## **Conclusion**

The [ASCERTAIN-TRD trial](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503923/) and similar studies reinforce the outdated nature of resistance to TMS and provide substantial reassurance to clinicians, patients, service providers, and [third-party payers](https://www.ncbi.nlm.nih.gov/books/NBK384616/) of its safety and efficacy as a treatment option.

[Click here if you would like to find out more about being referred to our clinics for TMS](https://www.mmhg.com.au/contact) 

 

 

 

 

References: Beck, J. S., & Beck, A. T. (1995). *Cognitive therapy: Basics and beyond*. Guilford Press New York; Cosci, F., Guidi, J., Mansueto, G., & Fava, G. A. (2020). Psychotherapy in recurrent depression: efficacy, pitfalls, and recommendations. *Expert Review of Neurotherapeutics, 20*(11), 1169-1175; George, M. S., Nahas, Z., Molloy, M., Speer, A. M., Oliver, N. C., Li, X.-B., Arana, G. W., Risch, S. C., & Ballenger, J. C. (2000). A controlled trial of daily left prefrontal cortex TMS for treating depression. *Biological psychiatry, 48*(10), 962-970; Harmer, C. J., Duman, R. S., & Cowen, P. J. (2017). How do antidepressants work? New perspectives for refining future treatment approaches. *The Lancet Psychiatry, 4*(5), 409-418.; Harris, R. (2019). *ACT made simple: An easy-to-read primer on acceptance and commitment therapy*. New Harbinger Publications.; Kandola, A., Ashdown-Franks, G., Hendrikse, J., Sabiston, C. M., & Stubbs, B. (2019). Physical activity and depression: Towards understanding the antidepressant mechanisms of physical activity. *Neuroscience & Biobehavioral Reviews, 107*, 525-539.; Sonmez, A. I., Camsari, D. D., Nandakumar, A. L., Voort, J. L. V., Kung, S., Lewis, C. P., & Croarkin, P. E. (2019). Accelerated TMS for depression: a systematic review and meta-analysis. *Psychiatry Research, 273*, 770-781.

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