Repeated transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation method that may be preferred as an augmentation strategy for psychiatric patients who may not have responded well enough to psychotropic drugs. In psychoses rTMS may act via changing cortical excitability, connectivity and plasticity. rTMS may induce transcallosal inhibition and antipsychotic drugs may extend the duration of this inhibition. We present a first episode psychosis patient initially unresponsive to antipsychotic treatment, in whom 20 sessions of right 1Hz rTMS augmentation resulted in clinical response and who remained in remission by the 8th month of treatment. We suggest that rTMS is a well-tolerated treatment that may not be reserved only for treatment resistant patients but may also be considered early on in the management of psychiatric disorders.
Repeated Transcranial Magnetic Stimulation, augmentation, first episode psychosis, antipsychotic augmentation