Repetitive TMS Effective for Comorbid Major Depressive Disorder, Anxiety

In those with comorbid major depressive and anxiety disorders, 23.3% met criteria for remission.

Repetitive transcranial magnetic stimulation (rTMS) showed efficacy in patients with major depressive disorder (MDD) and comorbid anxiety, according to results from a study published in the Journal of Affective Disorders.

Researchers conducted a single-site, nonrandomized, comparison study of 248 patients who received rTMS therapy for treatment-resistant MDD. Among those included, 172 participants had a minimum of 1 comorbid anxiety disorder, and their results were compared with those for patients without comorbid anxiety. Depression and anxiety scores were measured using common instruments, such as the Hamilton Anxiety Rating Scale, the 21-item Hamilton Rating Scale for Depression, and the Montgomery-Asberg Depression Scale.

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After analysis, the researchers found that rTMS therapy showed clinical efficacy both in patients with MDD alone and in those with comorbid anxiety. In patients with comorbid anxiety disorders, 39.5% met response criteria and 23.3% met criteria for remission. In addition, the researchers found no significant difference between the groups with respect to response rate (P <.795).

One key limitation of the study was the lack of a placebo group.

“This study showed that rTMS is equally effective for treating depression, regardless of whether there are comorbid anxiety disorders or not,” the researchers wrote. “[There] is a role for future research into TMS as a treatment for patients with anxiety conditions without major depression.”


Clarke E, Clarke P, Gill S, Paterson T, Hahn L, Galletly C. Efficacy of repetitive transcranial magnetic stimulation in the treatment of depression with comorbid anxiety disorders. J Affect Disord. 2019;252:435-439.