Depressive disorders are common in the older patients. There is a high level of non-response in this population. While there are many treatments available, side effects to medication continues to be a major issue. Electro Convulsive Therapy (ECT) is commonly used, but is associated with a high incidence of cognitive side effects. We hypothesized that rTMS may be a useful treatment for depressed elderly.

Elderly (over 60 years) in or out patients with Major Depressive Episode within Major Depressive or Bipolar Disorders were treated open label with high frequency, left sided repetitive transcranial magnetic stimulation (rTMS) for ten sessions. They all had at least one adequate trial of antidepressants or mood stabilizers

Twenty nine patients, average age 69.3, range 60-89, 41% males, took part in this prospective study. Hamilton Depression Rating Scale score reduced from 24 at baseline to 17 at the end of treatment and to 16 two weeks after the treatment ended. Hamilton Anxiety Rating Scale also reduced from 20 to 14. There were no cognitive side effects as measured by MMSE. Only one patient dropped out of the study due to side effects

rTMS seems to be a safe and effective method for treatment of depressed elderly patients. There is a need of larger randomized controlled studies.