Clinical efficacy and safety of repetitive transcranial magnetic stimulation in acute bipolar depression

McGirr, Alexander; Karmani, Sneha; Arsappa, Rashmi; Berlim, Marcelo T.; Thirthalli, Jagadisha; Muralidharan, Kesavan; Yatham, Lakshmi N.

doi:10.1002/wps.20300

Cited by 72 publications

(61 citation statements)

References 19 publications

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“…rTMS targeted at the left or right dorsolateral prefrontal cortex (level 3)275 may also be used in addition to medication. Other classes of antidepressants such as serotonin‐ norepinephrine reuptake inhibitors [SNRIs] and monoamine oxidase inhibitors [MAOIs] could be used adjunctively but clinicians need to ensure adequate anti‐manic prophylaxis in such situations, as SNRIs and MAOIs have a higher propensity than other antidepressants to induce manic switch and cause mood destabilization (level 2) 276, 277, 278…”

Section: Acute Management Of Bipolar Depressionmentioning

confidence: 99%

“…A number of agents do not have sufficient data to warrant specific recommendations for BDII depression, including cranial electrotherapy stimulation (CES),479 dextromethorphan + quinidine,480 light therapy,481, 482, 483, 484, 485 lisdexamfetamine (adjunctive),300 olanzapine,486 pioglitazone,302 adjunctive pregnenolone,306 celecoxib,297 levetiracetam,487 adjunctive lisdexamfetamine,300 s‐adenosylmethionine,488, 489, 490 acetyl‐ l ‐carnitine + alpha‐lipoic acid,491 adjunctive modafinil,268 rTMS,275, 492, 493 and memantine 494…”

Section: Bipolar II Disordermentioning

confidence: 99%

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Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

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The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, second, and third‐ line treatments, with consideration given to levels of evidence for efficacy, clinical support based on experience, and consensus ratings of safety, tolerability, and treatment‐emergent switch risk. New to these guidelines, hierarchical rankings were created for first and second‐ line treatments recommended for acute mania, acute depression, and maintenance treatment in bipolar I disorder. Created by considering the impact of each treatment across all phases of illness, this hierarchy will further assist clinicians in making evidence‐based treatment decisions. Lithium, quetiapine, divalproex, asenapine, aripiprazole, paliperidone, risperidone, and cariprazine alone or in combination are recommended as first‐line treatments for acute mania. First‐line options for bipolar I depression include quetiapine, lurasidone plus lithium or divalproex, lithium, lamotrigine, lurasidone, or adjunctive lamotrigine. While medications that have been shown to be effective for the acute phase should generally be continued for the maintenance phase in bipolar I disorder, there are some exceptions (such as with antidepressants); and available data suggest that lithium, quetiapine, divalproex, lamotrigine, asenapine, and aripiprazole monotherapy or combination treatments should be considered first‐line for those initiating or switching treatment during the maintenance phase. In addition to addressing issues in bipolar I disorder, these guidelines also provide an overview of, and recommendations for, clinical management of bipolar II disorder, as well as advice on specific populations, such as women at various stages of the reproductive cycle, children and adolescents, and older adults. There are also discussions on the impact of specific psychiatric and medical comorbidities such as substance use, anxiety, and metabolic disorders. Finally, an overview of issues related to safety and monitoring is provided. The CANMAT and ISBD groups hope that these guidelines become a valuable tool for practitioners across the globe.

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Section: Acute Management Of Bipolar Depressionmentioning

confidence: 99%

Section: Bipolar II Disordermentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

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“…Supportive meta-analyses are now available for rTMS in treating SUD (Gorelick et al, 2014; Dunlop et al, 2016), PTSD (Berlim and Van Den Eynde, 2014), bipolar disorder (McGirr et al, 2016) and OCD (Berlim et al, 2013a; Trevizol et al, 2016). …”

Section: Targeting the Sn-cstc With Therapeutic Brain Stimulationmentioning

confidence: 99%

Cortico-Striatal-Thalamic Loop Circuits of the Salience Network: A Central Pathway in Psychiatric Disease and Treatment

Peters

Dunlop

Downar³

2016

Front. Syst. Neurosci.

430

298

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The salience network (SN) plays a central role in cognitive control by integrating sensory input to guide attention, attend to motivationally salient stimuli and recruit appropriate functional brain-behavior networks to modulate behavior. Mounting evidence suggests that disturbances in SN function underlie abnormalities in cognitive control and may be a common etiology underlying many psychiatric disorders. Such functional and anatomical abnormalities have been recently apparent in studies and meta-analyses of psychiatric illness using functional magnetic resonance imaging (fMRI) and voxel-based morphometry (VBM). Of particular importance, abnormal structure and function in major cortical nodes of the SN, the dorsal anterior cingulate cortex (dACC) and anterior insula (AI), have been observed as a common neurobiological substrate across a broad spectrum of psychiatric disorders. In addition to cortical nodes of the SN, the network’s associated subcortical structures, including the dorsal striatum, mediodorsal thalamus and dopaminergic brainstem nuclei, comprise a discrete regulatory loop circuit. The SN’s cortico-striato-thalamo-cortical loop increasingly appears to be central to mechanisms of cognitive control, as well as to a broad spectrum of psychiatric illnesses and their available treatments. Functional imbalances within the SN loop appear to impair cognitive control, and specifically may impair self-regulation of cognition, behavior and emotion, thereby leading to symptoms of psychiatric illness. Furthermore, treating such psychiatric illnesses using invasive or non-invasive brain stimulation techniques appears to modulate SN cortical-subcortical loop integrity, and these effects may be central to the therapeutic mechanisms of brain stimulation treatments in many psychiatric illnesses. Here, we review clinical and experimental evidence for abnormalities in SN cortico-striatal-thalamic loop circuits in major depression, substance use disorders (SUD), anxiety disorders, schizophrenia and eating disorders (ED). We also review emergent therapeutic evidence that novel invasive and non-invasive brain stimulation treatments may exert therapeutic effects by normalizing abnormalities in the SN loop, thereby restoring the capacity for cognitive control. Finally, we consider a series of promising directions for future investigations on the role of SN cortico-striatal-thalamic loop circuits in the pathophysiology and treatment of psychiatric disorders.

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“…Given the largely shared symptomatology and neurophysiology of BPD and MDD, rTMS applied to the DLPFC is also used to treat BPD. In this disorder, rTMS has shown similar efficacy in reducing symptoms of depression without inducing a treatment‐emergent affective switch to manic episodes . Kazemi et al .…”

Section: Bipolar Disordermentioning

confidence: 99%

“…In this disorder, rTMS has shown similar efficacy in reducing symptoms of depression without inducing a treatment-emergent affective switch to manic episodes. 40 Kazemi et al 41 investigated the network-level effects from bilateral rTMS treatment applied to the DLPFC in 20 patients with BPD, which was assessed using resting state EEG without TMS. As measured through functional network analyses, responders showed lower activity in the default mode network at baseline and decreases in sensorimotor network connectivity after treatment.…”

Section: Prognostic and Predictive Purpose Of Biomarkersmentioning

confidence: 99%

The Current and Future Potential of Transcranial Magnetic Stimulation With Electroencephalography in Psychiatry

Hui

Tremblay

Daskalakis

2019

Clin Pharma and Therapeutics

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The search for biological targets in psychiatric disorders is essential to better understand illness mechanisms and also to monitor and predict response to currently available therapeutic interventions. To this end, the combination of transcranial magnetic stimulation with electroencephalography (TMS‐EEG) has emerged as a powerful clinical research tool. TMS‐EEG allows cortical properties, such as excitability, inhibition, oscillatory activity, and connectivity, to be directly probed within a specific region of the cortex. This review will summarize the state of the current literature on TMS‐EEG and its potential to uncover biological targets in psychiatric illnesses, with a focus on major depressive disorder, bipolar disorder, and schizophrenia. Collectively, the reviewed studies suggest that alterations in gamma‐aminobutyric acid‐mediated inhibition and gamma oscillations in the dorsolateral prefrontal cortex and neighboring frontal regions are potential shared biomarkers in psychiatry, highlighting the potential of TMS‐EEG to help identify translational biomarkers.

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Clinical efficacy and safety of repetitive transcranial magnetic stimulation in acute bipolar depression

Cited by 72 publications

References 19 publications

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Cortico-Striatal-Thalamic Loop Circuits of the Salience Network: A Central Pathway in Psychiatric Disease and Treatment

The Current and Future Potential of Transcranial Magnetic Stimulation With Electroencephalography in Psychiatry

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