Somani Aditya, Kar Sujita Kumar
Department of Psychiatry, Mental Health Institute, Chandigarh, India.
Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India.
Gen Psychiatr. 2019 Aug 12;32(4):e100074. doi: 10.1136/gpsych-2019-100074. eCollection 2019.
Depression is a common mental disorder, which attributes to significant morbidity, disability and burden of care. A significant number of patients with depression still remain symptomatic after adequate trials of antidepressant treatment as well as psychotherapy, which is often referred to as treatment-resistant depression. Neuromodulation techniques-like electroconvulsive therapy, vagus nerve stimulation, transcranial magnetic stimulation (TMS) and transcranial direct current stimulation, may be useful augmenting techniques in depression, mostly recommended for treatment-resistant cases. Robust evidence exists regarding the efficacy of electroconvulsive therapy in the management of treatment-resistant depression; however, other techniques are understudied. TMS has been increasingly studied in various psychiatric disorders including depression. It has been approved by the US Food and Drug Administration for use in major depressive disorder. Over the past two decades, TMS has been studied in diverse groups of the population with depression using several research designs. This article gives an overview of the efficacy of repetitive TMS in treatment-resistant depression with the recent evidence.
抑郁症是一种常见的精神障碍，会导致严重的发病率、残疾和护理负担。相当一部分抑郁症患者在经过充分的抗抑郁治疗和心理治疗试验后仍有症状，这通常被称为难治性抑郁症。神经调节技术，如电休克疗法、迷走神经刺激、经颅磁刺激（TMS）和经颅直流电刺激，可能是治疗抑郁症有用的辅助技术，主要推荐用于难治性病例。关于电休克疗法治疗难治性抑郁症的疗效有确凿证据；然而，其他技术的研究较少。TMS已在包括抑郁症在内的各种精神疾病中得到越来越多的研究。它已被美国食品药品监督管理局批准用于重度抑郁症。在过去二十年中，使用多种研究设计对不同抑郁症人群的TMS进行了研究。本文根据最新证据概述了重复经颅磁刺激治疗难治性抑郁症的疗效。
