Major depression or clinical depression is a mental health disorder characterized by an endlessly depressed mood that causes impairment in daily life. Various types of non-surgical simulations are available for the treatment of depression. The objective of this study is to evaluate the comparative efficacy and acceptability of non-surgical simulation for the acute treatment of major depressive episodes in adults.

This is a systematic review with pairwise and network meta-analysis based on the datasets of Medline, PubMed, Embase, and PsycINFO. The analysis included clinical trials with random allocation to transcranial magnetic stimulation (repetitive (rTMS), electroconvulsive therapy (ECT), magnetic seizure therapy, theta-burst stimulation, sham therapy, or transcranial direct current stimulation (tDCS). The primary outcome of the study was the efficacy and discontinuation of the treatment. 

After the analysis of 6,750 participants from 113 trials, the odds ratio for the non-surgical techniques were as follows: bitemporal ECT (8.91), high dose right unilateral ECT (7.27), priming transcranial magnetic stimulation (6.02), magnetic seizure therapy (5.55), bilateral rTMS (4.92), bilateral theta burst stimulation (4.44), low-frequency right rTMS (3.65), intermittent theta-burst stimulation (3.20), high frequency left rTMS (3.17), and tDCS (2.65).

The research concluded that non-surgical stimulation techniques could be used as an alternative or add-on treatments for clinical depression.