intermediateTMStranscranial magnetic stimulationtreatment-resistant depressionneurostimulationDLPFCneuromodulation
A 45-year-old man with major depressive disorder has failed adequate trials of three antidepressants from different classes and two augmentation strategies over the past two years. His current PHQ-9 score is 19, he has no psychotic features, and he denies active suicidal ideation but reports passive death wishes. He has no history of seizure disorder, no intracranial metallic implants, and no cardiac pacemaker. He has not previously received electroconvulsive therapy or transcranial magnetic stimulation. He inquires about TMS as a treatment option. The PMHNP is evaluating whether TMS is appropriate and planning the treatment protocol. Which of the following best describes appropriate treatment planning for TMS in this patient?