Is rTMS effective in the treatment of anxiety disorders?

So far, research on repetitive transcranial magnetic stimulation (rTMS) has largely focused on depression and schizophrenia, and results have been inconsistent. Some of the problems have been that without any guidelines, rTMS techniques vary as to the part of the brain targeted, the precision of the targeting, and the intensity of the cycle.

A pilot study published in The Journal of Clinical Psychiatry attempted to determine if rTMS guided by functional magnetic resonance imaging (fMRI) could have a measurable effect on symptoms of generalized anxiety disorder GAD). Ten participants enrolled in the UCLA Anxiety Disorders Program completed six sessions of rTMS over the course of three weeks. Before treatment, each person was assessed with fMRI to determine the most active areas of the prefrontal cortex. Then, rTMS treatments were focused on these areas.

At the end of treatment, six of the 10 subjects showed significant decrease in anxiety symptoms and were rated "improved" or "much improved" on the measurement scales used in the study. Although the results are promising, the researchers point out that because of the small number of participants and constraints in the design of the study, more research is needed to determine whether rTMS is indeed an effective option for treating anxiety disorders.

Despite its lack of proven effectiveness so far, doctors have continued to recommend rTMS as a treatment for anxiety disorders largely because side effects are so minimal. However, rTMS is not as convenient as taking a medication, and it can be costly.