Schizophrenia is a serious mental disorder that affects thinking, emotional life, motivation, and daily functioning. In addition to the more well-known positive symptoms such as hallucinations and delusions, many patients also experience so-called negative symptoms. These include, among others, loss of initiative, reduced emotional responsiveness, social withdrawal, low energy, and cognitive difficulties.

Negative symptoms are often long-lasting and have a major impact on functioning and quality of life. At the same time, they are generally difficult to treat, as they respond only to a limited extent to antipsychotic medication. Research suggests that negative symptoms are associated with reduced activity in prefrontal brain regions, which are central to motivation, planning, and emotional regulation.

This reduced prefrontal activity can make it harder for the brain to initiate actions, regulate emotions, and maintain social contact—even when positive symptoms are well controlled.

In schizophrenia, rTMS is primarily used with the aim of reducing negative symptoms. The treatment targets prefrontal brain regions that are often underactive in patients with pronounced negative symptoms.

Repeated stimulation over several weeks can increase activity in these areas and contribute to more adaptive regulation of networks involved in motivation, initiative, and emotional responsiveness. The treatment is not intended to replace antipsychotic medication, but is used as a supplement in selected patients.

Treatment takes place at the clinic. You remain awake throughout the session and can go home afterwards. A session typically lasts between 20 and 40 minutes depending on the protocol, and a treatment course often extends over several weeks.

Studies show that rTMS can reduce negative symptoms in some patients with schizophrenia. Improvements are typically seen as increased energy, better initiative, greater emotional presence, and improved ability to engage in daily activities and social interaction.

The effect develops gradually over time and is related to neuroplasticity—the brain’s ability to change its function through repeated stimulation. It is important to be realistic: rTMS does not work for everyone, and the effect varies. In some, improvement is clear; in others, more modest; and some experience no significant change.

Side effects are usually mild and transient. The most common are mild headache or discomfort during stimulation, particularly at the beginning of the course.

Treatment of schizophrenia typically consists of:

• Antipsychotic medication

• Psychosocial support and rehabilitation

• Psychotherapeutic and cognitive interventions

• Social support and structured daily-life programmes

While medication is often effective for positive symptoms, treatment options for negative symptoms are limited. rTMS differs in that it directly targets the brain regions involved in negative symptoms and may, in selected patients, be a relevant supplement to existing treatment.