INTRODUCTION: The aim of this preliminary report is to demonstrate the efficacy of rapid transcranial magnetic stimulation (rTMS) in the treatment of relapsed major depressive disorder (MDD) patients. METHODS: Four patients with major depressive disorder who were successfully treated with rTMS received a second course of rTMS treatment. Patients were evaluated with the Hamilton Depression Rating Scale &#45 21 items, the Brief Psychiatric Rating Scale, the Global Depression Scale and the Global Assessment Scale in both trials. The statistical analysis was performed with paired t-tests and chi squares. RESULTS: Clinical ratings demonstrated a significant improvement at the end of both trials. No significant differences were found between the ratings at the end of the treatment courses. CONCLUSION: rTMS was successfully used in the treatment of relapsed MDD patients who had previously responsed to rTMS. ( Int J Psych Clin Pract 2000; 4: 223 - 226)