Explaining rTMS vs implants vs ECT for TRD (CASC)

Station instructions (candidate)

You have 7 minutes. Explain why, after several adequate antidepressant failures, rTMS/iTBS is a reasonable next outpatient option: how sessions work (daily weeks; optional shorter iTBS), common side effects (scalp discomfort, headache; rare seizure), need for safety screening, and realistic response rates — not a guaranteed cure. Briefly place VNS (implant, delayed benefit, mixed acute RCT vs longer-term data) and DBS (specialist research; major controlled trials for key targets did not meet primary endpoints) so 'more invasive' is not sold as 'more proven'. Compare with ECT without stigma theatre: ECT remains important for more severe or urgent presentations and for some who do not respond to rTMS. Check understanding; invite questions; offer written information and crisis contacts.^{[1][2][3][4][5][6]}