Right prefrontal TMS versus sham treatment of mania: a controlled study

Kaptsan, Alexander; Yaroslavsky, Yuri; Applebaum, Julia; Belmaker, R.H.; Grisaru, Nimrod

doi:10.1034/j.1399-5618.2003.00003.x

Cited by 81 publications

(45 citation statements)

References 10 publications

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“…A possible alternative to ECT as a physical treatment, repetitive transcranial magnetic stimulation (rTMS) has not been shown to have unequivocal antimanic efficacy in a single blind study against sham-rTMS ( Kaptsan et al 2003) (CE ''E'').…”

Section: Physical Treatmentsmentioning

confidence: 99%

The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Update 2009 on the Treatment of Acute Mania

Grunze

Vieta

Goodwin

et al. 2009

The World Journal of Biological Psychiatry

316

247

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These updated guidelines are based on a first edition that was published in 2003, and have been edited and updated with the available scientific evidence until end of 2008. Their purpose is to supply a systematic overview of all scientific evidence pertaining to the treatment of acute mania in adults. The data used for these guidelines have been extracted from a MEDLINE and EMBASE search, from the clinical trial database clinicaltrials.gov, from recent proceedings of key conferences, and from various national and international treatment guidelines. Their scientific rigor was categorised into six levels of evidence (AÁF). As these guidelines are intended for clinical use, the scientific evidence was finally asigned different grades of recommendation to ensure practicability.

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Section: Physical Treatmentsmentioning

confidence: 99%

The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Update 2009 on the Treatment of Acute Mania

Grunze

Vieta

Goodwin

et al. 2009

The World Journal of Biological Psychiatry

316

247

View full text Add to dashboard Cite

show abstract

“…0.01) for patients treated with right, rather than left prefrontal TMS at 20 Hz. Although an open-label study using right high-frequency prefrontal TMS in the treatment of bipolar mania found that TMS was associated with a reduction in manic symptoms [55] , Kaptsan et al [56] could not replicate its result in a sham-controlled study.…”

Section: Tms In Maniamentioning

confidence: 97%

Transcranial Magnetic Stimulation in the Management of Mood Disorders

Allan

Herrmann²,

Ebmeier³

2011

Neuropsychobiology

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Background: Many trials of transcranial magnetic stimulation (TMS) have used small samples and, therefore, lack power. Here we present an up-to-date meta-analysis of TMS in the treatment of depression. Methods: We searched Medline and Embase from 1996 until 2008 for randomized sham-controlled trials, with patients and investigators blinded to treatment, and outcome measured using a version of the Hamilton Depression Rating Scale (or similar). We identified 1,789 studies. Thirty-one were suitable for inclusion, with a cumulative sample of 815 active and 716 sham TMS courses. Results: We found a moderately sized effect in favour of TMS [Random Effects Model Hedges’ g = 0.64, 95% confidence interval (95% CI) = 0.50–0.79]. The corresponding Pooled Peto Odds Ratio for treatment response (≤50% reduction in depression scores) was 4.1 (95% CI = 2.9–5.9). There was significant variability between study effect sizes. Meta-regressions with relevant study variables did not reveal any predictors of treatment efficacy. Nine studies included follow-up data with an average follow-up time of 4.3 weeks; there was no mean change in depression severity between the end of treatment and follow-up (Hedges’ g = –0.02, 95% CI = –0.22 to +0.18) and no heterogeneity in outcome. Discussion: TMS appears to be an effective treatment; however, at 4 weeks’ follow-up after TMS, there had been no further change in depression severity. Problems with finding a suitably blind and ineffective placebo condition may have confounded the published effect sizes. If the TMS effect is specific, only further large double-blind randomized controlled designs with systematic exploration of treatment and patient parameters will help to define optimum treatment indications and regimen.

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“…Response to right prefrontal rTMS was superior, with a 71% decline in mean YMRS scores, compared to left prefrontal rTMS (29% change). However, a sham-controlled, follow-up study by the same group in 25 manic patients found no difference between active and sham treatment, despite using the same treatment approach (Kaptsan et al 2003). In both studies, most patients were on concurrent medications (lithium, anticonvulsants, and/or antipsychotic medications).…”

Section: Rtms In the Treatment Of Acute Maniamentioning

confidence: 96%

Nonpharmacotherapeutic Somatic Treatments for Bipolar Disorder (ECT, DBS, rTMS)

Loo

Greenberg

Mitchell

2010

Behavioral Neurobiology of Bipolar Disorder and Its Treatment

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Nonpharmacotherapeutic, somatic treatments play an essential role in the management of bipolar disorder (BPD). Studies indicate that electroconvulsive therapy (ECT) is an effective treatment for acute mania, bipolar depression, and mixed affective states. Furthermore, it is an important second-line treatment option, as most pharmacotherapy-resistant patients respond to ECT. Specific challenges for patients with BPD receiving ECT include the risk of mood switching, and the need to evaluate and manage concurrent treatment with lithium and anticonvulsant mood stabilizers. Although the current evidence for alternative and newer physical treatments (e.g., transcranial magnetic stimulation, vagus nerve stimulation, stereotactic ablation, and deep brain stimulation) is preliminary, all of these novel methods show promising potential and merit further research.

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Right prefrontal TMS versus sham treatment of mania: a controlled study

Cited by 81 publications

References 10 publications

The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Update 2009 on the Treatment of Acute Mania

The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Update 2009 on the Treatment of Acute Mania

Transcranial Magnetic Stimulation in the Management of Mood Disorders

Nonpharmacotherapeutic Somatic Treatments for Bipolar Disorder (ECT, DBS, rTMS)

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