Application of transcranial magnetic stimulation in treatment of drug-resistant major depression—a report of two cases

We report the cases of two drug-resistant major depressed psychotic patients, who were treated with 10 sessions of transcranial magnetic stimulations (TMS) and afterwards with 10 sessions of electroconvulsive therapy (ECT) without changing the concomitant neuroleptic and antidepressive medication. TMS did not exert a therapeutic effect in one patient and only a slight one in the other. However, there was a clear beneficial effect for ECT in the patient not responding to TMS and a slight therapeutic effect in the other. In summary, there was no clear-cut evidence for effectiveness of TMS as a treatment for patients with psychotic, therapy resistant depression. However, since there was a slight therapeutic effect of TMS in one patient it seems worthwhile to explore its therapeutic efficacy in a larger group of depressed patients.