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Evaluating the Efficacy of Accelerated Transcranial Magnetic Stimulation for Suicidal IdeationAccelerated magnetic stimulation shows no clear edge for suicidal thoughts

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Key Takeaway
Accelerated TMS is a feasible but not significantly superior treatment for reducing suicidal ideation compared to standard methods.

This systematic review and meta-analysis evaluated the impact of accelerated transcranial magnetic stimulation (aTMS) on patients aged 12 and older suffering from depressive disorders and suicidality. The study specifically looked at whether increasing the frequency of sessions provided a significant clinical advantage over sham or standard TMS protocols.

Results indicated that while aTMS is a feasible treatment option, it did not demonstrate a statistically significant advantage over sham or standard treatments in reducing suicidal ideation immediately post-treatment or during follow-up periods. Furthermore, no significant differences were found regarding the reduction of overall depressive symptoms.

From a safety perspective, adverse events were generally mild, though they occurred more frequently in the accelerated group. Dropout rates remained comparable across both groups, suggesting that while the treatment is tolerable and feasible, current evidence does not support it as a superior method for rapid suicidality reduction.

When someone is struggling with depression and thoughts of suicide, every treatment option matters. Researchers looked at a specific method called accelerated transcranial magnetic stimulation (aTMS). This involves giving patients more frequent sessions, specifically two or more per day, to see if it works better than standard treatments for those in crisis.

The study looked at 310 people over the age of 12 who were dealing with depressive disorders and suicidal thoughts. While aTMS is a feasible option that people can tolerate well, the data showed it did not provide a significant advantage over sham or standard magnetic stimulation. This applies to both immediate results after treatment and follow-up periods.

There was a slight trend suggesting a better response rate for those using accelerated sessions, but this result was not statistically significant. Additionally, while patients who received the accelerated treatment reported more frequent side effects, these were generally mild. Because of differences in how the treatments were set up across different studies, the overall certainty of the evidence remains unclear.

What this means for you:
Accelerated magnetic stimulation is a feasible option but does not show superior results for reducing suicidal thoughts.

Common questions

Is accelerated magnetic stimulation safer than standard treatment?

The study found that while side effects were more frequent with accelerated treatment (OR = 1.95), these events were generally mild. The dropout rates between the two groups were similar, and the overall feasibility of the treatment was considered acceptable.

Does accelerated treatment work faster for suicidal thoughts?

The data did not show a significant advantage for accelerated treatment over sham or standard methods regarding the severity of suicidal ideation. While there was a non-significant trend favoring accelerated sessions in response rates, it was not enough to confirm it as superior.

Who is this treatment intended for?

The study included individuals aged 12 and older who were experiencing depressive disorders and suicidal ideation. If you or a loved one are seeking treatment, please consult a doctor to discuss these options.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJul 2026
View Original Abstract ↓
BACKGROUND: Accelerated transcranial magnetic stimulation (aTMS), which delivers multiple stimulation sessions per day over a condensed treatment period, has been proposed as a rapid intervention for suicidality in depressive disorders, but the quality and certainty of supporting evidence remain unclear. This systematic review and meta-analysis assessed the efficacy, safety, and feasibility of aTMS in reducing suicidality. METHODS: PubMed, Embase, Scopus, and Web of Science were searched through April 30, 2025, for randomized controlled trials (RCTs) and open-label studies on aTMS (≥2 sessions/day) in individuals aged >12 years with depressive disorders and suicidality. The primary outcome was change in suicidal ideation severity, assessed using validated clinician-rated or self-reported suicidality scales. Secondary outcomes included suicidality at follow-up, response rates, depressive symptoms, adverse effects, and dropout rates. Risk of bias was assessed using RoB 2 and ROBINS-I, and certainty of evidence was rated via GRADE. Meta-analyses used a random-effects model. RESULTS: Thirteen studies (7 RCTs, 6 open-label; N = 625) met inclusion criteria; six RCTs (N = 310) were included in the meta-analysis. aTMS showed no significant advantage over sham or standard TMS for suicidality post-treatment (SMD = 0.17; 95% CI -0.62, 0.95), at follow-up (SMD = 0.76; -0.14, 1.65), or for depressive symptoms (SMD = 1.05; -0.28, 2.39). Suicidality response (OR = 1.55) showed a non-significant trend favoring aTMS. Adverse effects were generally mild but more frequent with aTMS (OR = 1.95); dropout rates were similar (OR = 1.47). DISCUSSION: Current evidence does not support accelerated TMS as superior to sham or standard TMS for reducing suicidality; however, its feasibility appears acceptable. Open-label studies suggest potential benefits of personalized, fMRI-guided targeting approaches. Interpretation of these findings is limited by substantial heterogeneity in stimulation protocols and comparator conditions across included trials. PROSPERO registration: CRD42024623555.
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