Philip Noah S, Carpenter S Louisa
Center for Neurorestoration and Neurotechnology, Providence VA Medical Center, Department of Psychiatry & Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA.
F1000Res. 2013 Dec 24;2:284. doi: 10.12688/f1000research.2-284.v1. eCollection 2013.
Repetitive transcranial magnetic stimulation (rTMS) is a comparatively novel option for the treatment of major depressive disorder (MDD) and other psychiatric illnesses. Previous research has shown rTMS to be safe and without significant side effects compared to pharmacologic options. However, rare cases of rTMS-induced mania have been reported. This case report describes such an affective switch in a 52 year old female veteran with treatment-resistant MDD and a history of electroconvulsive therapy (ECT)-induced mania. Six treatments of rTMS were administered at 5 Hz for a total of 3000 pulses per day, when the patient began to display multiple hypomanic symptoms. These symptoms decreased after the termination of treatment and abated within a couple of days. In conclusion, caution should be used when administering rTMS to patients with a history of ECT-induced mania.
重复经颅磁刺激（rTMS）是治疗重度抑郁症（MDD）和其他精神疾病的一种相对较新的选择。先前的研究表明，与药物治疗相比，rTMS是安全的，且无明显副作用。然而，已有rTMS诱发躁狂的罕见病例报告。本病例报告描述了一名52岁患有难治性MDD且有过电休克治疗（ECT）诱发躁狂病史的退伍女性出现的这种情感转换。当患者开始出现多种轻躁狂症状时，以5赫兹的频率进行了6次rTMS治疗，每天共3000个脉冲。这些症状在治疗终止后减轻，并在几天内消退。总之，对有ECT诱发躁狂病史的患者进行rTMS治疗时应谨慎。
