Miuli A, Sepede G, Stigliano G, Mosca A, Di Carlo F, d’Andrea G, Lalli A, Spano MC, Pettorruso M, Martinotti G, di Giannantonio M. Hypomanic/manic switch after transcranial magnetic stimulation in mood disorders: A systematic review and meta-analysis. World J Psychiatr 2021; 11(8): 477-490 [PMID: 34513609 DOI: 10.5498/wjp.v11.i8.477]
Corresponding Author of This Article
Francesco Di Carlo, MD, Doctor, Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti, ITAB-Via dei Vestini 33, Chieti 66100, Italy. francesco.dic@hotmail.it
Research Domain of This Article
Psychiatry
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Psychiatr. Aug 19, 2021; 11(8): 477-490 Published online Aug 19, 2021. doi: 10.5498/wjp.v11.i8.477
Hypomanic/manic switch after transcranial magnetic stimulation in mood disorders: A systematic review and meta-analysis
Andrea Miuli, Gianna Sepede, Gianfranco Stigliano, Alessio Mosca, Francesco Di Carlo, Giacomo d’Andrea, Aliseo Lalli, Maria Chiara Spano, Mauro Pettorruso, Giovanni Martinotti, Massimo di Giannantonio
Andrea Miuli, Gianna Sepede, Gianfranco Stigliano, Alessio Mosca, Francesco Di Carlo, Giacomo d’Andrea, Aliseo Lalli, Mauro Pettorruso, Giovanni Martinotti, Massimo di Giannantonio, Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti, Chieti 66100, Italy
Maria Chiara Spano, Department of Psychiatry Affective Neuropsychiatry, Sahlgrenska University Hospital, Göteborg 40530, Sweden
Giovanni Martinotti, Department of Pharmacy, Clinical Science, University of Hertfordshire, Herts AL10 9AB, Italy
Author contributions: Miuli A, Sepede G, Pettorruso M, Martinotti G and di Giannantonio M designed the research study; Miuli A, Stigliano G, Mosca A, Di Carlo F, d’Andrea G, Lalli A and Spano MC performed the research; Miuli A and Sepede G analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Francesco Di Carlo, MD, Doctor, Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti, ITAB-Via dei Vestini 33, Chieti 66100, Italy. francesco.dic@hotmail.it
Received: February 16, 2021 Peer-review started: February 16, 2021 First decision: March 16, 2021 Revised: March 24, 2021 Accepted: July 20, 2021 Article in press: July 20, 2021 Published online: August 19, 2021
ARTICLE HIGHLIGHTS
Research background
One of the most innovative and most investigated non-invasive brain stimulation techniques is Transcranial Magnetic Stimulation (TMS). This device has received Food and Drug Administration approval for the treatment of various neurological (headache) and psychiatric (treatment resistant depression) disorders. Several studies have been conducted to find new applications of TMS in conditions that do not respond or partially respond to standard psychopharmacological therapies.
Research motivation
TMS is an increasingly used technique in the neurological and psychiatric fields. One of the greatest concerns about its use is the possibility of developing severe side effects such as hypomanic/manic switches (HMS).
Research objectives
The aim of this meta-analysis is to quantify the risk of developing HMS after treatment with TMS in mood disorders and to evaluate the drop-out rate due to that adverse event.
Research methods
The search was conducted using PubMed, Scopus and Web of Science databases on March 22, 2020. All procedures were registered on PROSPERO and performed according to the PRISMA guidelines. Only double blind/single blind articles, written in English were included. RevMan 5.4 Software for Windows was used to perform the meta-analysis.
Research results
Of the 25 eligible studies, only four HMSs were described. No dropouts were reported due to symptoms severity.
Research conclusions
Our data confirm that, by applying appropriate psychopharmacological and anamnestic precautions, TMS is a safe technique for treating mood disorders.
Research perspectives
Greater uniformity of protocols, their online registration and the timely reporting of side effects on scientific papers could guarantee a more accurate analysis of the health risks induced by TMS in future meta-analyses.
