The Emerging Role for Repetitive Transcranial Magnetic Stimulation in Optimizing the Treatment of Adolescent Depression
- 1 December 2010
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in The Journal of ECT
- Vol. 26 (4), 323-329
- https://doi.org/10.1097/yct.0b013e3181dd17eb
Abstract
Major depressive disorder (MDD) in adolescents is a common illness and significant public health problem. Treatment is challenging because of recurrences and limited modalities. Selective serotonin reuptake inhibitors and cognitive behavioral therapy are considered the standard of care in severe or treatment-resistant MDD in this age group. However, responses to these interventions are often suboptimal. A growing body of research supports the efficacy of repetitive transcranial magnetic stimulation (rTMS) for the treatment of MDD in adults. Induced seizures are a primary safety concern, although this is rare with appropriate precautions. There is, however, limited experience with rTMS as a therapeutic intervention for adolescent psychiatric disturbances. This review will summarize the rTMS efficacy and safety data in adults and describe all published experience with adolescent MDD. Applications in other adolescent psychiatric illnesses such as schizophrenia and attention-deficit/hyperactivity disorder are reviewed. Safety and ethical issues are paramount with investigational treatments in adolescent psychiatric illnesses. However, further research with rTMS in adolescent MDD is imperative to establish standards for optimal stimulation site, treatment parameters, and its role in treatment algorithms. These may diverge from adult data. Early intervention with neuromodulation could also hold the promise of addressing the developmental course of dysfunctional neurocircuitry.Keywords
This publication has 81 references indexed in Scilit:
- Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and researchClinical Neurophysiology, 2009
- Transient suppression of seizures by repetitive transcranial magnetic stimulation in a case of Rasmussen’s encephalitisEpilepsy & Behavior, 2008
- Switching to Another SSRI or to Venlafaxine With or Without Cognitive Behavioral Therapy for Adolescents With SSRI-Resistant DepressionJAMA, 2008
- Transcranial Magnetic Stimulation in Child Neurology: Current and Future DirectionsJournal of Child Neurology, 2007
- An 11-year-old boy with drug-resistant schizophrenia treated with temporo-parietal rTMSMolecular Psychiatry, 2007
- Transcranial magnetic stimulation in adolescent depressionAustralasian Psychiatry, 2006
- Transcranial magnetic stimulation in adolescent depressionAustralasian Psychiatry, 2006
- Natural Course of Adolescent Major Depressive Disorder in a Community Sample: Predictors of Recurrence in Young AdultsAmerican Journal of Psychiatry, 2000
- The efficacy of cognitive-behavioral and interpersonal treatments for depression in Puerto Rican adolescents.Journal of Consulting and Clinical Psychology, 1999
- Seizure induction and transcranial magnetic stimulationThe Lancet, 1992