Is electroconvulsive therapy still given in bipolar disorder and does repetitive transcranial magnetic stimulation offer more?

2005 ◽  
pp. 211-218
Keyword(s):  
Bipolar Disorder ◽  
Transcranial Magnetic Stimulation ◽  
Electroconvulsive Therapy ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation

Repetitive transcranial magnetic stimulation as a maintenance therapy strategy after electroconvulsive therapy: a conceptual review

2016 ◽  
Vol Ano 6 ◽  
pp. 6-13
Author(s):  
Mercedes Jurema Oliveira Alves
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Maintenance Therapy ◽  
Electroconvulsive Therapy ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Therapy Strategy

O presente texto faz uma revisão das bases teóricas e dos estudos empíricos disponíveis sobre o uso da estimulação magnética transcraniana de repetição como estratégia terapêutica de manutenção após eletroconvulsoterapia. Há quadros psiquiátricos pouco responsivos a quaisquer tipos de tratamentos, inclusive à eletroconvulsoterapia. O texto mostra que a combinação das técnicas é promissora, porém mais estudos são necessários para se definir as indicações precisas e a eficácia em termos de sustentação da resposta terapêutica.

scholarly journals Repetitive transcranial magnetic stimulation treatment for peripartum depression: systematic review & meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hyune June Lee ◽  
Sung Min Kim ◽  
Ji Yean Kwon
Keyword(s):  
Systematic Review ◽  
Transcranial Magnetic Stimulation ◽  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Effect Size ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Peripartum Depression

Abstract Background Peripartum depression is a common disorder with very high potential hazards for both the patients and their babies. The typical treatment options include antidepressants and electroconvulsive therapy. However, these treatments do not ensure the safety of the fetus. Recently, repetitive transcranial magnetic stimulation has emerged as a promising treatment for neuropathies as well as depression. Nevertheless, many studies excluded pregnant women. This systematic review was conducted to confirm whether repetitive transcranial magnetic stimulation was a suitable treatment option for peripartum depression. Methods We performed a systematic review that followed the PRISMA guidelines. We searched for studies in the MEDLINE, PsycINFO, EMBASE, and Cochrane library databases published until the end of September 2020. Eleven studies were selected for the systematic review, and five studies were selected for quantitative synthesis. Data analysis was conducted using Comprehensive Meta-Analysis 3 software. The effect size was analyzed using the standardized mean difference, and the 95% confidence interval (CI) was determined by the generic inverse variance estimation method. Results The therapeutic effect size of repetitive transcranial magnetic stimulation for peripartum depression was 1.394 (95% CI: 0.944–1.843), and the sensitivity analysis effect size was 1.074 (95% CI: 0.689–1.459), indicating a significant effect. The side effect size of repetitive transcranial magnetic stimulation for peripartum depression was 0.346 (95% CI: 0.214–0.506), a meaningful result. There were no severe side effects to the mothers or fetuses. Conclusions From various perspectives, repetitive transcranial magnetic stimulation can be considered an alternative treatment to treat peripartum depression to avoid exposure of fetuses to drugs and the severe side effects of electroconvulsive therapy. Further research is required to increase confidence in the results.

scholarly journals Repetitive transcranial magnetic stimulation in the treatment of bipolar disorder

2020 ◽  
Vol 10 ◽  
pp. 204512532097379
Author(s):  
Danielle Hett ◽  
Steven Marwaha
Keyword(s):  
Bipolar Disorder ◽  
Transcranial Magnetic Stimulation ◽  
Side Effects ◽  
Magnetic Stimulation ◽  
Sleep Problems ◽  
Bipolar Depression ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Controlled Trial ◽  
Total N ◽  
Depressive Episodes

Bipolar disorder (BD) is a debilitating mood disorder marked by manic, hypomanic and/or mixed or depressive episodes. It affects approximately 1–2% of the population and is linked to high rates of suicide, functional impairment and poorer quality of life. Presently, treatment options for BD are limited. There is a strong evidence base for pharmacological (e.g., lithium) and psychological (e.g., psychoeducation) treatments; however, both of these pose challenges for treatment outcomes (e.g., non-response, side-effects, limited access). Repetitive transcranial magnetic stimulation (rTMS), a non-invasive brain stimulation technique, is a recommended treatment for unipolar depression, but it is unclear whether rTMS is an effective, safe and well tolerated treatment in people with BD. This article reviews the extant literature on the use of rTMS to treat BD across different mood states. We found 34 studies in total ( N = 611 patients), with most assessing bipolar depression ( n = 26), versus bipolar mania ( n = 5), mixed state bipolar ( n = 2) or those not in a current affective episode ( n = 1). Across all studies, there appears to be a detectable signal of efficacy for rTMS treatment, as most studies report that rTMS treatment reduced bipolar symptoms. Importantly, within the randomised controlled trial (RCT) study designs, most reported that rTMS was not superior to sham in the treatment of bipolar depression. However, these RCTs are based on small samples ( NBD ⩽ 52). Reported side effects of rTMS in BD include headache, dizziness and sleep problems. Ten studies ( N = 14 patients) reported cases of affective switching; however, no clear pattern of potential risk factors for affective switching emerged. Future adequately powered, sham-controlled trials are needed to establish the ideal rTMS treatment parameters to help better determine the efficacy of rTMS for the treatment of BD.

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