Outcome of Repetitive Transcranial Magnetic Stimulation Therapy in Patients with Severe Depression: An Indian Clinical Study

Abstract Background: Severe depression is associated with marked functional impairment and an inadequate response to conventional pharmacotherapy in a considerable proportion of patients. Repetitive Transcranial Magnetic Stimulation (rTMS) has emerged as a promising non-invasive neuromodulation technique for managing severe depressive episodes. Aims: To evaluate the clinical outcomes of rTMS therapy in patients with severe depression attending a tertiary care psychiatric centre in India. Settings and Design: This prospective clinical study was conducted at MGM Medical College and Hospital, Jaipur, from April 2024 to November 2025. Materials and Methods: A total of 150 patients diagnosed with severe depressive disorder according to standard diagnostic criteria were enrolled. All participants received rTMS therapy as per institutional protocol along with standard treatment. Depression severity was assessed at baseline and at 4, 8, 12, 16, and 20 weeks using standardized depression rating scales to evaluate treatment response over time. Statistical Analysis Used: Changes in depression severity scores during follow-up were analyzed using appropriate statistical methods to determine the significance of symptom reduction and response trends. Results: Most patients showed progressive and sustained improvement in depressive symptoms. Minimal change was noted at early assessments (4–8 weeks), while clinically significant improvement became evident by 16 weeks and further increased at 20 weeks. A substantial proportion achieved meaningful symptom reduction, indicating a delayed yet robust therapeutic response. Conclusions: rTMS appears to be an effective and well-tolerated treatment for severe depression, with optimal benefits observed after sustained therapy and regular follow-up.