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Journal of ECT:
doi: 10.1097/YCT.0000000000000145
Case Report: PDF Only

Magnetic Seizure Therapy-induced Mania: A Report of 2 Cases.

Noda, Yoshihiro MD, PhD; Daskalakis, Zafiris J. MD, PhD, FRCPC; Fitzgerald, Paul B. MBBS, MPM, PhD, FRANZCP; Downar, Jonathan MD, PhD; Rajji, Tarek K. MD, FRCPC; Blumberger, Daniel M. MD, MSc, FRCPC

Published Ahead-of-Print
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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.

(C) 2014 by Lippincott Williams & Wilkins

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