Treating depression with magnetic stimulation
rTMS for depression
What often improves:
For treatment-resistant depression, the German national guideline recommends rTMS (grade B, 2022). In a registry covering 103 practices, 58 to 69 % of the 5,010 patients treated with TMS responded (Sackeim et al. 2020). We treat with the theta burst protocol; in the largest randomised trial on it (Blumberger et al. 2018, The Lancet, n=414) the figure was 49 %, and 32 % reached remission three months after the series.
rTMS is considered well tolerated: most commonly a feeling of pressure at the treated spot, less often headaches. A single session takes only a few minutes.
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How rTMS acts in the brain
There are more than 29,000 scientific articles on rTMS, over 5,000 of them on depression.
A magnetic field
The magnetic field passes through scalp and skull unimpeded and stimulates the nerve cells in the target area.
Dorsolateral prefrontal cortex
We target the left dorsolateral prefrontal cortex. This region is often underactive in depression. Intensity and position are set for you beforehand.
Repetition and plasticity
A single pulse only acts for milliseconds. Only repetition across a whole series - hence “repetitive” - produces longer-lasting changes in signal transmission between nerve cells.
Reclaiming everyday life
New energy, new perspectives - step by step
How your rTMS treatment works
Initial consultation (free of charge)· approx. 30-45 min.
Dr. Schwarz discusses your situation, your treatment history and your goals.
First session & treatment series
After your motor threshold has been determined, 20-30 treatments follow over one to three weeks. A treatment takes only a few minutes. You sit awake in the treatment chair and feel the pulses as a light tapping on the scalp.
Joint review
At the end we discuss the course of treatment, the next steps and whether maintenance sessions are advisable.
Is neurostimulation suitable for you?
Not every patient benefits equally. Answer a few short questions about your situation - we review your information personally and get back to you.
- A few short questions · just a few minutes
- Personal response from Dr. Schwarz
- Response by email within 24 hours
- Confidential in accordance with medical confidentiality and GDPR
Non-invasive
No surgery, no anaesthesia
No medication
Acts locally, not systemically
A few minutes
Theta burst protocol per session
Medically led
Indication, threshold and follow-up
Dr. Tim Schwarz
Dr. Tim Schwarz führt die Behandlung mit medizinischer Sorgfalt und persönlicher Begleitung der Patientinnen und Patienten.
Clinical expertise
Trained at:
Experience gained at the practice of his father, Dr. Schwarz in Ulm - specialised in non-invasive brain stimulation for many years.
Personally there for you
- No referral needed
- Discreet, empathetic consultation
- Clear information on costs and options - before treatment begins
Get in touch
Whether you are affected yourself or a relative, you are welcome to write to us without obligation - our practice team will get back to you.
Your questions about rTMS
Still have questions? We answer everything in a personal initial consultation.
On this topic
Understanding depression: symptoms, causes and treatment at a glance
What the research shows
rTMS for depression has been the subject of controlled trials for more than two decades. Three of them, each with its limitations.
Theta burst on a par with classic rTMS
In the THREE-D trial (Blumberger et al. 2018, The Lancet, n=414), HAMD-17 scores fell under theta burst stimulation almost identically to the established 10 Hz rTMS - with a session lasting around three minutes instead of a good 37.
In context
A non-inferiority trial without a sham arm: it demonstrates the equivalence of the two active protocols, not superiority over sham treatment.
Under everyday conditions
In an observational study across 42 US practices (Carpenter et al. 2012, n=307), 58.0% of patients showed a clinical response and 37.1% achieved remission.
In context
An observation without a control group, so a placebo share cannot be separated out. Its strength lies in transferability to routine care, not in proof of efficacy.
Sham-controlled and industry-independent
In an NIH-funded trial at four US university hospitals (George et al. 2010, n=190), 14.1% of patients achieved remission under active rTMS compared with 5.1% under sham treatment.
In context
Only treatment-resistant patients were studied, and the absolute remission rates in the double-blind phase were low.
The German National Care Guideline on Unipolar Depression (2022) recommends that rTMS “should be offered for treatment-resistant depressive episodes” (recommendation 7-29, grade B).
To the guidelineAnd if rTMS is not the right fit?
Then transcranial direct current stimulation (tDCS) may be an option. It works with a weak direct current through electrodes on the scalp rather than with magnetic pulses. The headset used for it is approved for the treatment of unipolar depression in adults, explicitly including use at home; unsuccessful prior treatment with medication is not a prerequisite.