How effective is repetitive transcranial magnetic stimulation for bipolar depression?
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Bipolar depression is difficult to treat (Fountoulakis et al., 2007, Malhi et al., 2015) and is considered the most disabling component of bipolar disorder (Judd et al., 2003). Antidepressant medication is often ineffective, and there is a risk of both a switch to mania, and acceleration of rapid cycling.
Various other treatment options have been considered, including Electroconvulsive Therapy (ECT) and repetitive Transcranial Magnetic Stimulation (rTMS). Repetitive TMS is a non-invasive
Role of Funding
This study was funded by Ramsay Health Care (SA) Mental Health Services.
Contributors
Benjamin L. Carnell., Patrick Clarke., Shane Gill., Cherrie A. Galletly.
Conflict of Interest Statement
None to declare.
Acknowledgments
The authors wish to acknowledge Carol Turnbull (CEO, The Adelaide Clinic), Dr. Tom Paterson, and the TMS Unit clinical staff.
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Cited by (16)
Could bipolar depressed patients respond better to rTMS than unipolar depressed patients? A naturalistic, observational study
2022, Psychiatry ResearchCitation Excerpt :Our findings in this naturalistic, observational study suggest rTMS is an effective treatment for bipolar depression. In that respect, our findings are consistent with those of Carnell et al., Dolberg et al., and Kim and Jung, among others (Carnell et al., 2017; Dolberg et al., 2002; Kim and Jung, 2011; Tamas et al., 2007). They are inconsistent with an RCT that showed no evidence HF left-sided rTMS was effective for treating BD in a sample of 23 patients (Nahas et al., 2003) and with two larger RCTs of rTMS for BD (Fitzgerald et al., 2016; Hu et al., 2016).
An update on the clinical use of repetitive transcranial magnetic stimulation in the treatment of depression
2020, Journal of Affective DisordersCitation Excerpt :There is clearer evidence supporting the use of rTMS in bipolar depression from studies in mixed samples. Studies have reported no difference in response rates (e.g. Carnell et al. (2017)) or a trend favouring response in bipolar subjects (e.g. Fitzgerald et al. (2006e)). A meta-analysis including data from all accessible bipolar depression trials found a significant benefit of active over sham stimulation (McGirr et al., 2016).
Twice-daily neuronavigated intermittent theta burst stimulation for bipolar depression: A Randomized Sham-Controlled Pilot Study
2019, Neurophysiologie CliniqueCitation Excerpt :To our knowledge, more than twenty open-label naturalistic studies investigating the efficacy of rTMS in bipolar depression have been conducted. Most of them have used high frequency (HF) rTMS and some have suggested comparable efficacy of rTMS in treating bipolar and unipolar depression (e.g. [2]). However, few controlled studies have been designed to investigate the effect of rTMS specifically in bipolar depression.
Mood disorders: When should we use repetitive transcranial magnetic stimulation?
2019, Presse MedicaleEfficacy of repetitive transcranial magnetic stimulation in the treatment of depression with comorbid anxiety disorders
2019, Journal of Affective DisordersCitation Excerpt :This dataset reflects patients seen in routine psychiatric practice. Articles have been previously published using participants included in this dataset on: the efficacy of rTMS for bipolar depression (Carnell et al., 2017); the safety profile of rTMS (Clarke et al. 2015); a comparison of right unilateral and sequential bilateral rTMS for major depression (Galletly et al. 2017); the efficacy of rTMS 3 days per week versus 5 days per week (Galletly et al., 2012); and the efficacy of rTMS for young people who have not responded to antidepressant treatment (Rosenich et al., 2018). Patients were referred for rTMS by private psychiatrists credentialed with Ramsay Health Care (SA) Mental Health Services.
Clinical Repetitive Transcranial Magnetic Stimulation for Posttraumatic Stress Disorder, Generalized Anxiety Disorder, and Bipolar Disorder
2018, Psychiatric Clinics of North AmericaCitation Excerpt :Several studies investigating rTMS for depression included patients with bipolar disorder as well as MDD. Especially in early trials, the number of participants was too small to adequately assess for differences in response or safety between the conditions, but rTMS seemed to work similarly in both conditions.56–58 One of the first randomized trials for rTMS, specifically for depressive episodes in patients with bipolar disorder (ie, bipolar depression), was reported by Dolberg and colleagues59 in 2002.
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Corresponding author. The Adelaide Clinic, Suite 13, 33 Park Tce, Gilberton, SA, 5081. Tel.: +08 82698144; fax: +08 82696187. [email protected].