Curr Psychiatry Rep. 2013
Jul;15(7):368. doi: 10.1007/s11920-013-0368-1.
What is the role of brain stimulation therapies in the treatment of depression?
Source
Campbell Family Research Institute, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, 1001 Queen St. W. Unit 4, Room 115, Toronto, ON, M6J 1H4, Canada, daniel.blumberger@camh.ca.Abstract
Brain stimulation therapies have demonstrated efficacy in the treatment of
depression and treatment-resistant depression (TRD). Non-invasive brain
stimulation in the treatment of depression has grown substantially due to their
favorable adverse effect profiles. The role of transcranial direct current
stimulation in TRD is unclear, but emerging data suggests that it may be an
effective add-on treatment. Repetitive transcranial magnetic stimulation has
demonstrated efficacy in TRD that is supported by several multicenter randomized
controlled trials. Though, vagus nerve stimulation has been found to be
effective in some studies, sham controlled studies were equivocal.
Electroconvulsive therapy (ECT) is a well-established brain stimulation
treatment for severe depression and TRD, yet stigma and cognitive adverse
effects limit its wider use. Magnetic seizure therapy has a more favorable
cognitive adverse effect profile; however, equivalent efficacy to ECT needs to
be established. Deep brain stimulation may play a role in severe TRD and
controlled trials are now underway.
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