An individual patient data meta-analysis pooling 42 randomized controlled trials and 4,200 patients found no clinically meaningful difference in depression outcomes between intermittent theta burst stimulation (iTBS) and standard 10Hz repetitive TMS. The analysis, published in The Lancet Psychiatry, settles a question that has lingered since iTBS received FDA clearance in 2018.
Response rates were 49% for iTBS and 50% for 10Hz across the pooled trials. Remission rates were 30% and 32% respectively. iTBS sessions averaged 9.5 minutes of stimulation versus 37.5 minutes for 10Hz, with no difference in safety profile.
For clinics, the practical implication is throughput: a chair occupied 10 minutes per patient instead of 40 can serve four times as many patients per day. The authors note that this should translate into shorter waitlists and lower per-session costs, though insurance reimbursement currently does not differentiate between protocols.
The Clinical TMS Society released a statement endorsing iTBS as a first-line option for major depressive disorder, with the caveat that some patient subgroups — particularly those with severe psychomotor retardation — may still benefit from longer protocols based on subgroup analyses.
Source
Reporting based on coverage from The Lancet Psychiatry. This article is editorial summary intended for general information; it is not medical advice.