de Bruijn A, Tendolkar I, Spijker J, Lochmann van Bennekom M, van Eijndhoven P
Tijdschr Psychiatr. 2017;59(10):605-611.
Repetitive transcranial magnetic stimulation (rTMS) has been found to be an effective technique in the treatment of unipolar depression. However, it is not yet clear whether rTMS is also useful in the treatment of bipolar depression.
To evaluate the available evidence that rTMS is effective in the treatment of bipolar depression.
Review of available literature (RCTs and open-label studies).
We looked closely at four RCTs and four open-label studies. In three of the four RCTs the results for patients who had received rTMS were no better than those for patients who had received a placebo. Patients in all four open-label studies showed significant improvement. One individual developed hypomanic symptoms. The studies used many different parameters; some studies included diagnoses, some referred to the type of medication used.
So far, there is a lack of high quality studies on which we can base our conclusions about the effectiveness of rTMS for the treatment of bipolar depression. The use of rTMS to treat patients with bipolar depression does not seem to increase the risk that a patient will develop (hypo)mania.
重复经颅磁刺激（rTMS）已被证明是治疗单相抑郁症的有效技术。然而，rTMS在双相抑郁症治疗中是否同样有效尚不清楚。
评估rTMS治疗双相抑郁症有效性的现有证据。
回顾现有文献（随机对照试验和开放标签研究）。
我们仔细研究了四项随机对照试验和四项开放标签研究。在四项随机对照试验中的三项里，接受rTMS治疗的患者结果并不优于接受安慰剂治疗的患者。在所有四项开放标签研究中，患者均有显著改善。有一名患者出现了轻躁狂症状。这些研究使用了许多不同的参数；一些研究纳入了诊断信息，一些提到了所用药物的类型。
到目前为止，缺乏高质量的研究来支撑我们对rTMS治疗双相抑郁症有效性得出结论。使用rTMS治疗双相抑郁症患者似乎不会增加患者出现（轻）躁狂的风险。
