No sex difference in the antidepressive effect of transcranial magnetic stimulation (TMS): results from a retrospective analysis of a large real-world sample

World J Biol Psychiatry. 2025 Apr;26(4):170-178. doi: 10.1080/15622975.2025.2488357. Epub 2025 Apr 24.

ABSTRACT

OBJECTIVES: There is only limited knowledge about the impact of sex on the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in depressive disorders. Here, we analysed a large real-world sample of depressive patients with respect to potential sex-specific effects of rTMS treatment.

METHODS: Data of 984 patients (539 females/445 males) were analysed. Patients received various antidepressant TMS protocols, most of them 10Hz, 20 Hz, Theta burst or accelerated protocols over the left dorsolateral prefrontal cortex. Changes in Hamilton Depression Scale (HAMD) and Major Depression Inventory (MDI) scores as well as response and remission rates were compared between female and male patients.

RESULTS: There were no significant differences in any outcome between female and male patients. Response rates according to the HAMD-21 scores were 34.3% for females and 30.1% for males, according to the MDI 33.1% and 33.5% respectively. In an additional explorative analysis there was a tendency towards better outcome for females for the 20 Hz protocol.

CONCLUSIONS: The antidepressive effectiveness of rTMS does not differ between men and women.

PMID:40272912 | DOI:10.1080/15622975.2025.2488357