Repetitive Transcranial Magnetic Stimulation Treatment for Depressive Disorders
A Practical Guide
Fitzgerald, Paul B, Daskalakis, Z. Jeff
2013, X, 125 p. 11 illus., 10 illus. in color.
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Repetitive transcranial magnetic stimulation (rTMS) treatment is increasingly being used in the management of patients with depression. Since the approval of one rTMS device in the United States in 2008, clinical services using this equipment have become relatively common there, and services are also being developed in a variety of other countries. However, considerable ignorance exists about the treatment in general psychiatric practice. This concise clinical guide will serve as a reference and practical tool for clinicians working with or learning about this treatment technique.
The opening chapters provide basic information on the history and development of rTMS treatment and its mechanism of action. Use of the treatment in depression is then addressed in detail, with explanation of the evidence base and discussion of clinical issues such as selection of patients and type of treatment, dose, and treatment duration. Side-effects of treatment are explored, and careful consideration is given to various practical issues concerning the establishment of rTMS treatment programs and the training of clinicians. The final chapters will provides a brief overview of potential rTMS applications in other psychiatric conditions and some background on the use of related treatments, such as transcranial direct current stimulation.
TMS and rTMS: Basic Principles.- History of TMS and rTMS.- Mechanism of action: Plasticity, Inhibition, Molecular (i.e., BDNF).- Safety Considerations of rTMS in Depression.- Acute rTMS treatment for MDD - evidence base.- Acute rTMS treatment for MDD - clinical indications / patient selection.- Identification and Management of Side Effects.- Maintenance rTMS Treatment in MDD.- Practical issues: equipment, treatment program set up, certification, patient information.- Resources - include checklists, safety screens, symptom inventory etc.- rTMS applications in other disorders.- Novel rTMS treatment approaches in MDD.