Hypomanic/manic switch after transcranial magnetic stimulation in mood disorders:A systematic review and meta-analysis

作     者：Andrea Miuli Gianna Sepede Gianfranco Stigliano Alessio Mosca Francesco Di Carlo Giacomo d’Andrea Aliseo Lalli Maria Chiara Spano Mauro Pettorruso Giovanni Martinotti Massimo Di Giannantonio 

作者机构：Department of NeuroscienceImaging and Clinical Sciences“G.d'Annunzio”University of ChietiChieti 66100Italy Department of Psychiatry Affective NeuropsychiatrySahlgrenska University HospitalGöteborg 40530Sweden Department of PharmacyClinical ScienceUniversity of HertfordshireHerts AL109ABItaly 

出 版 物：《World Journal of Psychiatry》 (世界精神病学杂志)

年 卷 期：2021年第11卷第8期

页      面：477-490页

核心收录：

学科分类：1002[医学-临床医学] 100205[医学-精神病与精神卫生学] 10[医学] 

主　　题：Hypomanic/manic switch Transcranial magnetic stimulation Active vs sham comparison Mood disorders Adverse event Safety 

摘      要：BACKGROUND Nowadays there is an increasing use of transcranial magnetic stimulation(TMS)both in neurological and psychiatric *** Food and Drug Administration approval of TMS for the therapy of treatment-resistant depression,TMS has been widely used in the context of mood disorders(MD).However,growing reports regarding the possibility of developing hypomanic/manic switch(HMS)have generated concern regarding its use in *** To investigate the actual risk of developing HMS due to TMS in the treatment of *** We led our research on PubMed,Scopus and Web of Science on March 22,2020,in accordance to the PRISMA guidelines for systematic *** double blind/single blind studies,written in English and focused on the TMS treatment of MD,were included.A meta-analysis of repetitive TMS protocol studies including HMS was conducted using RevMan 5.4 *** assessment of Risk of Bias was done using Cochrane risk of bias *** protocol was registered on PROSPERO with the CRD42020175811 *** Twenty-five studies were included in our meta-analysis:Twenty-one double blind randomized controlled trials(RCT)and four single blind-RCT(*** subjects involved in active stimulation=576;*** subjects involved in sham protocol=487).The most frequently treated pathology was major depressive episode/major depressive disorder,followed by resistant depression,bipolar depression and other *** majority of the studies used a repetitive TMS protocol,and the left dorsolateral prefrontal cortex was the main target *** effects were reported in eight studies and HMS(described as greater energy,insomnia,irritability,anxiety,suicidal attempt)in four *** comparing active TMS vs sham treatment,the risk of developing HMS was not significantly different between *** Applying the most usual protocols and the appropriate precautionary measures,TMS seems not to be related to HMS development.