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Uninsured rTMS medical costs may be another issue in certain nations. 2\u2010Week prolonged intermittent theta\u2010burst stimulation (iTBS1800) to the left\u2010sided dorsolateral prefrontal cortex (DLPFC) demonstrated similar antidepressant efficacy to standard rTMS or iTBS in adults with TRD. However, no study has yet confirmed the antidepressant effect of iTBS1800 in geriatric TRD patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed chart data from May 2018 to September 2022 to identify TRD patients aged \u2265\u00a050\u00a0years who received self\u2010pay TMS treatments at a single medical center in Taiwan. All patients had major depressive disorder and had failed at least one prior antidepressant treatment. The Hamilton Depression Rating Scale (HDRS\u201017) was evaluated before and after TMS stimulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>97 older patients with TRD (mean\u00a0\u00b1\u00a0SD, age, 62.81\u00a0\u00b1\u00a07.89; 69.1%% female) was identified. Approximately 70% of patients reported anxious depression and prior antidepressant failures (\u2265\u00a03). The average number of self\u2010pay TMS sessions was 11.71\u00a0\u00b1\u00a03.15) (range:10\u201330). Patients receiving iTBS1800 demonstrated a greatly higher remission rate than those receiving 10\u00a0Hz rTMS (29.5% vs 13.2%, respectively, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.048), particularly in patients with mild and moderate depression. Age was not a clinically significant determinant of remission following TMS therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Left\u2010sided DLPFC iTBS1800 may be a feasible option for treating older patients with TRD due to its favorable effect and shorter treatment period, which may be ideal for patients with transportation, budgetary and vacation restrictions. More study is needed to compare the antidepressant efficacy of iTBS1800 to other TMS protocols in older patients with TRD.<\/jats:p><\/jats:sec>","DOI":"10.1002\/gps.70111","type":"journal-article","created":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T00:59:56Z","timestamp":1749776396000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Real\u2010World Effectiveness and Tolerability of Prolonged Intermittent Theta Burst Stimulation in Older Adults With Treatment\u2010Resistant Depression"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8334-0438","authenticated-orcid":false,"given":"Chih\u2010Ming","family":"Cheng","sequence":"first","affiliation":[{"name":"Department of Psychiatry Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Department of Psychiatry College of Medicine National Yang Ming Chiao Tung University  Taipei Taiwan"},{"name":"Institute of Brain 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