Repetitive transcranial magnetic stimulation for adults with treatment resistant major depressive disorder

31 December 2021

Published on 31 Dec 2021
Last Updated on 31 Dec 2021

Guidance Recommendation

The Ministry of Health’s Medical Technology Advisory Committee has recommended subsidy for:

A single course of repetitive transcranial magnetic stimulation (rTMS) therapy of up to a maximum of 24 sessions as initial treatment for adults (aged 18 years or more) with a diagnosis of treatment resistant major depressive disorder (TRD):
- Who failed to achieve satisfactory improvement despite adequate trialling of at least two different classes of antidepressants, unless these are contraindicated; AND
- Who have undertaken psychological therapy when appropriate and feasible; AND
- Who have not received treatment with rTMS previously.
A single course of rTMS retreatment of up to a maximum of 15 sessions for adults with TRD:
- Who have received initial treatment with rTMS and relapsed following remission or satisfactory clinical response, as assessed by a validated tool to measure the severity of major depressive disorder; AND
- Retreatment should start no sooner than four months after the end of initial treatment.
rTMS retreatment for patients with TRD who did not respond to rTMS initial treatment is not recommended.
rTMS as maintenance treatment for patients with TRD is not recommended.

Subsidies should apply to initial rTMS treatment and rTMS retreatment for adults with TRD, in line with stated recommendations.