Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2013 Apr 24;12(1):12.
doi: 10.1186/1744-859X-12-12.

Hypomanic shift observed during rTMS treatment of patients with unipolar depressive disorder: four case reports

Eylem Ozten  1 , Gokben Hizli Sayar, Oguz Karamustafalioglu
Affiliations
Case Reports

Hypomanic shift observed during rTMS treatment of patients with unipolar depressive disorder: four case reports

Eylem Ozten et al. Ann Gen Psychiatry. .

Abstract

Objective: Repetitive transcranial magnetic stimulation (rTMS) can enhance the excitement of the brain through adjusting the biological activities of the cerebral cortex and has wide biological effects, making it one basic mechanism of therapy for depression. In the treatment of unipolar depressive disorder, almost in every treatment method, hypomanic and manic shifts can be observed. There is still a lack of data regarding manic and hypomanic symptoms triggered by rTMS applications.

Method: We describe four cases with unipolar depression in which high-frequency rTMS over the left dorsolateral prefrontal cortex applied as an add-on antidepressive strategy may have induced a hypomanic episode.

Results: In these cases, 25 Hz rTMS combined with antidepressants may have contributed to the occurrence of hypomanic symptoms.

Conclusion: Using an intensive methodology of rTMS may induce hypomanic or manic symptoms.

PubMed Disclaimer

References

    1. Wassermann EM, Lisanby SH. Therapeutic application of repetitive transcranial magnetic stimulation: a review. Clin Neurophysio. 2001;112:1367–1377. doi: 10.1016/S1388-2457(01)00585-5. - DOI - PubMed
    1. Janicak PG, O'Reardon JP, Sampson SM, Husain MM, Lisanby SH, Rado JT, Heart KL, Demitrack MA. Transcranial magnetic stimulation in the treatment of major depressive disorder: a comprehensive summary of safety experience from acute exposure, extended exposure, and during reintroduction treatment. J Clin Psychiatry. 2008;69:222–232. doi: 10.4088/JCP.v69n0208. - DOI - PubMed
    1. Devanand DP, Sackeim HA, Decina P, Prudic J. The development of mania and organic euphoria during ECT. J Clin Psychiatry. 1988;49:69–71. - PubMed
    1. Sackeim HA, Rush AJ, George MS, Marangell LB, Husain MM, Nahas Z, Johnson CR, Seidman S, Giller C, Haines S, Simpson RK Jr, Goodman RR. Vagus nerve stimulation for treatment-resistant depression: efficacy, side effects and predictors of outcome. Neuropsychopharmacology. 2001;25:713–728. doi: 10.1016/S0893-133X(01)00271-8. - DOI - PubMed
    1. Colombo C, Benedetti F, Barbini B, Campori E, Smeraldi E. Rate of switch from depression into mania after therapeutic sleep deprivation in bipolar depression. Psychiatry Res. 1999;86:267–270. doi: 10.1016/S0165-1781(99)00036-0. - DOI - PubMed

Publication types

LinkOut - more resources