INTRODUCTION: Depressive disorders are among the most common mental health disorders worldwide and constitute a significant risk factor for suicidal ideation and behavior, making the search for effective treatments particularly important. In this context, much attention has been devoted to modern neuromodulation techniques that modify the activity of specific areas of the brain.

AIM(S): The aim of review is to compare the effectiveness of repetitive transcranial magnetic stimulation (rTMS) and intermittent theta burst stimulation (iTBS) in reducing suicidal ideation in patients with depression based on randomized clinical trials.

METHOD(S): The literature search was conducted in PubMed and Google Scholar databases using the logical operators AND and OR. The search strategy used a combination of keywords related to interventions, clinical diagnoses, and clinical outcomes, including: “TMS,” “rTMS,” “iTBS,” “NIBS,” “major depressive disorder,” “MDD,” “TRD,” “depression,” “suicide,” and “suicidal ideation.” The review included studies that met the following criteria: 1) randomized controlled trials (RCTs), 2) direct comparison of rTMS and iTBS protocols, 3) participation of individuals diagnosed with depressive disorders, 4) assessment of suicidal ideation as one of the clinical outcomes.

RESULTS: Three published studies met the inclusion criteria for this review.

CONCLUSIONS: Both rTMS and iTBS have been shown to be effective in reducing the severity of depressive symptoms, including suicidal ideation. The superiority of the prolonged version of iTBS over rTMS has been reported in only one study. From a clinical perspective, a significant advantage of iTBS is the much shorter duration of a single session compared to classic rTMS with a comparable safety profile, making this method more effective in terms of organization and potentially increasing the availability of treatment. Although both protocols are standard treatments, their relative efficacy and mechanisms of action require further investigation.