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This document, titled "TMS item number rules – what the evidence suggests," discusses the rules governing access to Medical Benefits Schedule item numbers for transcranial magnetic stimulation (TMS). The rules include restrictions on TMS rebates for patients who received TMS prior to November 2021, a lifetime limit of 50 TMS session rebates, and the exclusion of maintenance TMS from rebates. The document highlights the effectiveness of TMS in treating treatment-resistant depression (TRD) and the potential for relapse in patients taking antidepressant medication. It argues for the availability of TMS for all patients, the removal of the lifetime limit on TMS sessions, and the consideration of maintenance TMS as a treatment option. [Extracted from the article]

Objective: To determine the impact of clustered maintenance transcranial magnetic stimulation (TMS) on irritability occurring in treatment-resistant major depressive disorder (MDD).Method: A naturalistic study of 106 courses that includes pre- and posttreatment assessments of subjective and objective depression and a subjective measure of irritability developed for this study.Results: Forty-six participants (35 females), mean age 43.2 years (14.3), completed 106 courses. There was a significant reduction in irritability and depression scores (p < .001). The change in irritability scores was significantly correlated with the change in depression scores, r = .40, p < .001.Conclusion: TMS has the capacity to reduce the irritability co-occurring with treatment-resistant MDD, known to be responsive to TMS. This increases the possibility of using TMS in the treatment of irritability co-occurring with other disorders or standing alone (should irritability be categorized as a stand-alone disorder). [ABSTRACT FROM AUTHOR]