Abstract and Keywords
This article reviews the existing animal and human literature on the clinical potential of transcranial magnetic stimulation (TMS) in mania and bipolar depression, and discusses potential future directions for this work. Studies of TMS in depression and normal volunteers suggested lateral specificity of TMS-induced mood effects. Clinical trials to compare left versus right prefrontal TMS in mania have been developed. Studies to understand the effect of TMS in bipolar depression have been undertaken. The results show efficacy similar to that for unipolar depression. But this does not provide support for the concept of TMS as an anti-bipolar, or mood-stabilizing, treatment. The utility of TMS as prophylaxis for subsequent manic or depressive episodes has not been reported in bipolar disorder. More work is needed to clarify the risk of mood switch, and the potential of TMS as prophylaxis against future manic or depressive episodes.
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