Knox Erin D, Bota Robert G
Clinical Professor of Psychiatry, University of California, Riverside, Riverside, California.
Ment Health Clin. 2021 Nov 8;11(6):373-375. doi: 10.9740/mhc.2021.11.373. eCollection 2021 Nov.
Transcranial magnetic stimulation (TMS) is a noninvasive procedure used in the treatment of depression. We observed TMS-associated mania with psychotic symptoms in a 55-year-old male diagnosed with MDD and generalized anxiety disorder without history of psychosis or mania. Owing to poor pharmacotherapeutic response and worsening symptomatology, TMS was introduced while continuing phenelzine; this was initially successful in demonstrating positive effects on mood. However, the patient began to develop symptoms consistent with mania with psychosis and was hospitalized. Both TMS and phenelzine were discontinued, leading to significant improvement of the symptoms of mania and psychosis. Phenelzine was later reintroduced for maintenance treatment of depression and anxiety, with no recurrence of mania or psychosis. This case report implicates TMS as a possible cause of mania and psychosis symptoms.
经颅磁刺激（TMS）是一种用于治疗抑郁症的非侵入性程序。我们在一名55岁男性中观察到与经颅磁刺激相关的伴有精神病性症状的躁狂，该男性被诊断为重度抑郁症和广泛性焦虑症，无精神病或躁狂病史。由于药物治疗反应不佳且症状恶化，在继续使用苯乙肼的同时引入了经颅磁刺激；这最初成功地显示出对情绪有积极影响。然而，患者开始出现与伴有精神病的躁狂一致的症状并住院。经颅磁刺激和苯乙肼均被停用，导致躁狂和精神病症状显著改善。苯乙肼后来重新用于抑郁症和焦虑症的维持治疗，未再出现躁狂或精神病复发。本病例报告表明经颅磁刺激可能是躁狂和精神病症状的一个原因。
