Effects of Concomitant Use of Various Psychotropic Medications on the Treatment Response to Transcranial Magnetic Stimulation for Depression: A Literature Review.

Many patients are taking psychotropic medications concomitantly with repetitive transcranial magnetic stimulation (rTMS), the latter of which is indicated for the treatment of moderate and severe depressive episodes that have not responded to first-line pharmacotherapy. While preclinical evidence suggests that psychotropic drugs can generally affect rTMS, the specific effect on the clinical response of rTMS for depression is not fully clear. A systematic search of all papers published prior to January 2023 in PubMed, APA, PsycInfo, and Scopus was conducted to identify clinical studies that examine the effects of different psychotropic medications on clinical outcomes in patients undergoing rTMS for depression. A total of 10 articles were identified and extracted for inclusion. This review outlines the results from 10 clinical studies and summarizes the current state of the literature describing rTMS outcomes with concomitant use of several groups of psychotropic agents, including antipsychotics, mood stabilizers, psychostimulants, and benzodiazepines. Antidepressants were excluded from this review due to the evidence base that already exists describing their efficacy with and without rTMS.