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Preliminary evidence suggests that rTMS treatment of resistant depression in adolescents is not associated with long-term cognitive deterioration and that posttherapy clinical improvement can be maintained. It seems that some subjects may derive long-term benefit from the rTMS course.

Transcranial magnetic stimulation is relatively well tolerated by depressed adolescents, but it is also perceived as mostly unhelpful by them and their parents. This is at odds with emerging studies suggesting that rTMS can be an effective and safe treatment in this age group, indicating that further research is required to confirm our findings and understand reasons for any disparity.

Bupropion is antidepressant and a smoking cessation aid medication related to dopaminergic activity. We report for the first time a case of an older adult with a known tic disorder, which was in remission but exacerbated during treatment with bupropion. It has been reported that other dopaminergic compounds such as methylphenidate can exacerbate tic disorder. Clinicians should be aware of this potential adverse effect when prescribing bupropion to adults with tic and other motor disorders.

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