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Brain Stimul. 2017 Mar - Apr;10(2):260-262. doi: 10.1016/j.brs.2016.11.005. Epub 2016 Nov 14.

Treatment-emergent mania/hypomania during antidepressant treatment with transcranial direct current stimulation (tDCS): A systematic review and meta-analysis.

Author information

1
Service of Interdisciplinary Neuromodulation, Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil; Interdisciplinary Center for Applied Neuromodulation, University Hospital, University of São Paulo, São Paulo, Brazil. Electronic address: brunoni@usp.br.
2
Interdisciplinary Center for Applied Neuromodulation, University Hospital, University of São Paulo, São Paulo, Brazil.
3
Service of Interdisciplinary Neuromodulation, Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil; Interdisciplinary Center for Applied Neuromodulation, University Hospital, University of São Paulo, São Paulo, Brazil.
4
School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, Australia.
5
School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, Australia; St George Hospital, Sydney, Australia.

Abstract

BACKGROUND:

Treatment-emergent mania/hypomania (TEM) is a possible adverse effect of pharmacological and non-pharmacological antidepressant treatments.

OBJECTIVE:

We performed a systematic review and meta-analysis to evaluate the risk of TEM in depressed patients during randomized, sham-controlled trials (RCTs).

DATA SOURCES:

Medline database, from the first date available to August 12, 2016.

RESULTS:

From 283 references, 10 RCTs were identified. Only 3 of them described TEM. In active and sham groups, respectively, only 8 of 226 (3.5%) and 1 of 190 (0.5%) participants presented TEM. This difference was not statistically significant (OR = 1.79, 95% CI = 0.6 to 5.32). There were also five additional reports of TEM in participants not on RCTs. No risk factors for TEM were identified.

LIMITATIONS:

Low number of studies and TEM reports.

CONCLUSION:

Despite previous reports, active vs. sham tDCS was not associated with a significantly greater number of TEM episodes.

KEYWORDS:

Bipolar disorder; Major depressive disorder; Manic switch; Transcranial direct current stimulation; Treatment-emergent mania

PMID:
27916405
DOI:
10.1016/j.brs.2016.11.005
[Indexed for MEDLINE]

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