Transcranial magnetic stimulation for auditory hallucinations

NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 7 sources, which was discussed by the committee. The evidence included 1 systematic review, 5 randomised controlled trials (3 of which are also included in the systematic review) and 1 review of safety events (including some of the same studies that are included in the systematic review). It is presented in the summary of key evidence section in the overview. Other relevant literature is in the appendix of the overview.

The professional experts and the committee considered the key efficacy outcomes to be: remission or reduction of the intensity or frequency of auditory hallucinations, and improvement in quality of life.

The professional experts and the committee considered the key safety outcomes to be: headache, inadvertent muscle stimulation, exacerbation of symptoms, and seizures.

Patient commentary was sought but none was received.

The committee was informed that there is more than 1 device available for this procedure.

The committee noted that there is a placebo effect with this treatment.

Treatment may be targeted using imaging such as MRI or electroencephalogram (EEG).

This treatment is typically used as an adjunct to other therapies.

A wide variety of treatment protocols were used in the evidence considered by the committee.

The committee noted that most of the evidence it considered came from patients with schizophrenia.