not-yet-known not-yet-known not-yet-known unknown Discussion TRD presents a significant challenge in clinical practice, with current treatment guidelines often lacking evidence-based support. Consequently, better-quality research is essential to inform more effective management strategies. As existing treatments for resistant depression remain largely empirical, the absence of benchmark antidepressants hinders standardized approaches.1,2 Psychopharmacological interventions continue to be the mainstay for TRD treatment. Alternative therapies like neuromodulation, psychotherapy and T-PEMF have shown promising results. 3,5 -7 PEMF is a form of treatment that uses low-frequency electromagnetic waves to stimulate cells and tissues in the body. It has been shown to have potential anti-depressant effects by promoting neuronal activity and neuroplasticity. 8 In depression, T-PEMF therapy can be used to target the prefrontal cortex, which is a key area of the brain involved in mood regulation and cognitive function. It can also help improve mood, reduce anxiety and improve cognitive function in individuals with depression. 8 This may be particularly beneficial for patients with TRD who have failed to respond to traditional pharmacotherapy and psychotherapy.6,7 T- PEMF is applied via headsets or helmets that uses a magnetic field to induce electric currents in the brain. 8 Daily 20-30 minute sessions of T-PEMF in TRD patients showed significantly greater reduction in depressive symptoms than the sham group. 3 A meta-analysis evaluated the efficacy of repetitive transcranial magnetic stimulation (rTMS) and T-PEMF therapy for depression and concluded T-PEMF may have an effect on brain metabolism, neuronal connectivity, brain plasticity, and the immune system. Relatively few studies paid attention to the possible chronobiologic effects of electromagnetic fields. However the review concluded that magnetic fields influence divergent neurobiological processes. The antidepressant effect of T-PEMF may be specifically attributable to its effects on local brain activity and connectivity.8 T-PEMF was also shown effective in depression and anxiety in patients with Parkinson’s disease. 9 Full body PEMF, to the best of our knowledge, has not been investigated for TRD. In the present patient, full body PEMF QRS was used for CBP. However, patient reported significant improvement in both CBP and TRD symptoms. The decrease in pain NRS of CBP could have resulted in general well-being of patient contributing to decrease of depressive parameters. However present patient was a diagnosed case of TRD and had defaulted on treatment for past 3 months, thus the improvement in symptoms cannot be explained alone by the above. Thus, contributory role of PEMF QRS on both CBP and TRD is proposed. The authors feel that as full-body PEMF increases circulation in the entire body, promoting systemic effects it can potentially address multiple issues simultaneously, such as pain relief, inflammation reduction, improved circulation, and enhanced cellular function throughout the body. It may enhance cellular function in all tissues of the body with full-body PEMF optimizing their function and promoting better overall health leading to improved energy levels, enhanced metabolism, and better tissue repair. Thus, full body PEMF may result in systemic benefits and potentially benefit various systems in the body extrapolating to beneficial effects in TRD. 10 Further randomized trials to study the effect of full body PEMF on TRD should be undertaken. If found effective, the advantages of full body PEMF include easy operability, cheaper equipment and home application. T-PEMF also carries potential risks of seizures, interference with medical devices such as pacemakers, cochlear implants, or deep brain stimulators, headache and discomfort which is unsuitable for certain conditions like active tumors or brain injuries and thus requires hospital monitored administration. To conclude, full body PEMF via QRS may lead to successful remission of TRD, however further randomized controlled trials are needed to come to a definitive conclusion and maybe worthwhile to investigate considering its translational potential and morbidity of TRD.