Table 2 Studies excluded with reasons

Conca A, et al. Human Psychopharmacology. 2000 [44]

Did not examine effect of number of antidepressant trials on rTMS response

Cochrane Review. 2001 [45]

Review 17 years old. Did not examine effect on the number of antidepressant trials on rTMS response.

Holtzheimer PE, et al. Depression Anxiety. 2004 [46]

Patients treated with rTMS who responded/did not respond were identified as either having < 7 or > 7 antidepressant trials.

Mitchell PB, et al. Austral New Zeal Jrl Psych. 2006 [34]

Descriptive review of 25 rTMS studies. Stated that patients who were more treatment resistant (resistance not defined) were less likely to respond to rTMS.

CTAF, 2009 [47]

Review 8 years old. However did reference one study already included in assessement [18].

AHRQ. 2011 [35]

Did not examine number of failed medication trials effect on rTMS

Aguirre AK, et al. Jrl Affective Disord. 2011 [48]

Age only was examined as a predictor of rTMS efficacy.

Fitzgerald PB, et al. Expert Reviews 2011[49]

Stated patients were not treatment resistant. However, in examining paper, patients were found to have at least 2 failed medication trials.

Connolly KR, et al. Jrl, Clinical Psych 2012 [40]

Jrl Clin Psych 2017 rTMS consensus recommendations [10] stated there was no relationship between degree of treatment resistance and response to rTMS in this study. However, in this case series analysis it was found that patients were had an average of 3.4 failed medication trials and were found to be treatment resistant - with no direct comparison group.

NICE 2015 [36]

Did not examine number of failed medication trials effect on rTMS

Levkovitz Y, et al. World Psych. 2015 [8]

Multicenter (20 centers) RCT. Countries: 14 sites US, 4 Israel, Germany, and 1 Canada. Total of 212 patients (ITT), 181 patients (Per protocol). Comparison low medication treatment resistance (≤2 trials) to ≥3 failed treatments. Patients treated with rTMS who failed ≤2 treatments significantly more responsive (P = 0.032) than those with ≥3 treatments (P = 0.057).

Fitzgerald PB, et al. Depression Anxiety. 2016 [50]

Patients treated with rTMS who responded/did not respond had on average 5.7–6.1 failed medication trials. Could not break out low vs. high medication treatment resistance.