Magnetic Seizure Therapy-induced Mania: A Report of 2 Cases. Issue 1 (March 2015)

• Record Type: Journal Article
• Authors: Noda, Yoshihiro; Daskalakis, Zafiris J.; Fitzgerald, Paul B.; Downar, Jonathan; Rajji, Tarek K.; Blumberger, Daniel M.
• Is Part Of: Journal of ECT. Volume 31:Issue 1(2015:Mar.)
• Publication Date: 2015-03
• Subjects: magnetic seizure therapy -- treatment-resistant depression -- manic switch; Electroconvulsive therapy -- Periodicals; Shock therapy -- Periodicals; Electroconvulsive Therapy -- Periodicals; Electroconvulsive therapy; Shock therapy; Periodicals; Periodicals; Electronic journals; 616.89122
• DOI: 10.1097/YCT.0000000000000145
• Languages: English
• ISSNs: 1095-0680

Abstract

Abstract : Background: Magnetic seizure therapy (MST) is a novel brain stimulation modality used to treat refractory depression through the induction of seizures. It is currently being investigated as a potential alternative treatment to electroconvulsive therapy. To our knowledge, there have not been any previous reports of MST-induced mania. Objective: We aim to describe 2 cases of patients with a major depressive episode who developed acute symptoms of mania during a course of MST. Methods: The current report describes 2 cases of mania that occurred in the context of an ongoing open-label study of MST in treatment-resistant depression. The MST was administered 2 or 3 times per week and applied directly over the left and right dorsolateral prefrontal cortex. Treatment is administered until patients achieve remission or a maximum of 24 treatments. A MagVenture Twin coil and MST stimulator were used for treatment. The center of each coil was placed over F3 and F4 according to the 10–20 electroencephalography system. Results: Patient 1 had developed manic symptoms precipitously after the sixth MST treatment, and patient 2 developed manic symptoms after the 23rd MST treatment. In both patients, the MST treatment course was stopped. Their manic symptoms resolved rapidly with pharmacotherapy after cessation of MST treatments. Conclusions: As with electroconvulsive therapy, switches to mania or hypomania should be considered as potential adverse effects of MST.