Role of Electroconvulsive Therapy, Ketamine Infusion, and Deep Repetitive Transcranial Magnetic Stimulation in Treatment-Resistant Bipolar Depression: A Case Report.
Medicina (Kaunas)
; 60(6)2024 Jun 03.
Article
in En
| MEDLINE
| ID: mdl-38929552
ABSTRACT
Background and Objectives:
Options for treatment-resistant bipolar depression (TRBPD) are limited. Electroconvulsive therapy (ECT) has shown efficacy in TRBPD. However, the cognitive deficits and memory concerns associated with ECT are problematic for a significant number of patients. It remains unclear what the next step is for patients with TRBPD who fail ECT. Materials andMethods:
In this case report, we present a patient with TRBPD who sequentially received 12 sessions of brief-pulse right unilateral ECT, 22 sessions of ketamine infusion at 0.5-0.75 mg/kg for 40 min, and 39 sessions of deep repetitive transcranial magnetic stimulation (dTMS).Results:
The patient had some benefit from ECT, but declined continuation of ECT due to memory concerns. The patient tolerated ketamine infusion well but had limited benefit. However, the patient responded well to acute treatment with dTMS and maintained relative stability for more than 2 years.Conclusions:
This case suggests that patients with TRBPD who fail ECT and/or ketamine infusion might benefit from dTMS.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Bipolar Disorder
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Electroconvulsive Therapy
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Transcranial Magnetic Stimulation
/
Ketamine
Limits:
Adult
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Female
/
Humans
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Male
/
Middle aged
Language:
En
Journal:
Medicina (Kaunas)
Journal subject:
MEDICINA
Year:
2024
Document type:
Article
Affiliation country:
Country of publication: