EXOMIND & rTMS Calgary
rTMS vs Medication for Treatment-Resistant Depression
When depression has not improved enough, the decision is rarely as simple as choosing a device instead of a pill. rTMS and medication differ in how they are delivered, their side-effect patterns and the evidence supporting them.
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Why this matters
Quick answer: rTMS is a non-invasive, clinic-based treatment that targets brain networks using magnetic pulses. Medication affects the body systemically. Either may be used alone or as part of a broader plan.
Research Spotlight
Different tools, shared decision
- Non-invasive option
- Different side-effect profile
- Evidence varies by protocol
- Individual choice matters
How the options differ
rTMS
Treatment occurs through repeated clinic visits. It does not require anaesthesia and generally has limited systemic side effects. Common effects include temporary scalp discomfort or headache. Access, time commitment and protocol fit are practical considerations.
Medication
Medication is usually taken at home and can be effective and easier to integrate into a daily schedule. Side effects vary by medicine and person and can include sleep, digestive, sexual or weight-related effects. Medication changes require prescriber oversight.
What does the evidence say?
Meta-analytic evidence supports rTMS as an option for treatment-resistant major depression, but response is not guaranteed and estimates vary across protocols and study populations. A 2023 systematic review found active rTMS more effective than sham treatment across several commonly used protocols.
A better decision framework
- Review which treatments were tried, at what dose and for how long.
- Consider urgency, safety, side effects and practical access.
- Agree on symptom and function measures before treatment.
- Plan a review point and alternatives if progress is limited.
Research source
2023 systematic review and meta-analysis of rTMS for treatment-resistant depression.
Compare options with a clinician
A consultation can help organize your treatment history and determine whether EXOMIND rTMS deserves consideration.
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Reviewed by Dr. Courtney Dookie, Calgary Mind & Wellness Clinic.