Efficacy of high frequency (rapid) suprathreshold repetitive transcranial magnetic stimulation of right prefrontal cortex in bipolar mania: A randomized sham controlled study

Praharaj, Samir Kumar; Ram, Daya; Arora, Meenakshi

doi:10.1016/j.jad.2008.12.020

Cited by 86 publications

(56 citation statements)

References 28 publications

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“…Transcranial magnetic stimulation (rTMS) of the brain at 20 Hz over the right but not left frontal cortex or 1 Hz bi-frontally is reported to be efficacious. Data are, however, still insufficient and no conclusions can be drawn [147,362,423], although there is one controlled positive trial against acute mania [398].…”

Section: Methodsmentioning

confidence: 99%

Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry

Fountoulakis

Kasper

Andreassen

et al. 2012

Eur Arch Psychiatry Clin Neurosci

116

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Section: Methodsmentioning

confidence: 99%

Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry

Fountoulakis

Kasper

Andreassen

et al. 2012

Eur Arch Psychiatry Clin Neurosci

116

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“…Combination treatments with carbamazepine or oxcarbazepine (level 3),163 haloperidol (level 2),144, 164 or tamoxifen (level 2)165 plus lithium or divalproex are also included as third‐line. Repetitive transcranial magnetic stimulation (rTMS) in the right prefrontal cortex at 110% motor threshold (level 3)166 can also be considered in combination with pharmacotherapy.…”

Section: Acute Management Of Bipolar Maniamentioning

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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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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“…11 It has been proposed that in bipolar mania there is decreased cortical activity in the right side, with a relative increase in left-sided activity. 12 Moreover, TMS might have therapeutic effects in mania when the right prefrontal cortex is stimulated. 12 It has been thought that high-frequency (>1 Hz) TMS induces cortical excitation, whereas low-frequency (<1 Hz) causes cortical inhibition.…”

Section: To the Editormentioning

confidence: 99%

“…12 Moreover, TMS might have therapeutic effects in mania when the right prefrontal cortex is stimulated. 12 It has been thought that high-frequency (>1 Hz) TMS induces cortical excitation, whereas low-frequency (<1 Hz) causes cortical inhibition. 14 TMS appears to be relatively safe and well tolerated.…”

Section: To the Editormentioning

confidence: 99%

Use of Transcranial Magnetic Stimulation in Bipolar Disorder

Agarkar¹,

Mahgoub²,

Young³

2011

Journal of Neuropsychiatry

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Efficacy of high frequency (rapid) suprathreshold repetitive transcranial magnetic stimulation of right prefrontal cortex in bipolar mania: A randomized sham controlled study

Cited by 86 publications

References 28 publications

Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry

Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry

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

Use of Transcranial Magnetic Stimulation in Bipolar Disorder

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