This case series examined the therapeutic potential of repetitive transcranial magnetic stimulation in five female patients with comorbid chronic anorexia nervosa, major depressive disorder and personality disorder. 
Background: Anorexia nervosa (AN) is characterized by restricted eating, emaciation, and distorted body image and tends to be a chronic and deadly disorder with a high risk of developing a relapsing course described as a severe and enduring anorexia. To this day, there is no FDA approved pharmacotherapeutic treatment for AN. Also, AN is often found in comorbidity with depression and underlying structural  personality disorders. Transcranial magnetic stimulation (TMS) is a novel treatment, proved to be effective in reducing depressive symptoms, with developed protocols for treatment of anorexia nervosa. 
Materials and Methods: Participants received ~20 sessions of repetitive transcranial magnetic stimulation with the frequency 10 Hz to the left dorsolateral prefrontal cortex, 20 trains/day, 50 pulses/train, intertrain interval 55 s for 20 week days. Sociodemographic data, medical history, body mass index, eating disorder (ED) symptoms, mood and personality structure were assessed via standardized questionnaires and clinical interview pre-treatment and post-treatment and at 6-month follow-up. Qualitative feedback regarding the intervention was obtained from participants and carers.
Results and Conclusions: We showed that, in line with our positive clinical experiences with rTMS therapy in depression, the treatment of AN and comorbid depression and personality disorder, reduced our patient's anorexic, anxious, and depressive symptoms. This case study shows the need for further investigation of therapeutic benefits of rTMS in this specific patient population.

REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION TREATMENT IN PATIENTS WITH ANOREXIA NERVOSA COMORBID WITH DEPRESSION AND PERSONALITY DISORDER