Article

Magnetic seizure therapy of major depression.

Archives of General Psychiatry (Impact Factor: 13.75). 04/2001; 58(3):303-5. DOI: 10.1001/archpsyc.58.3.303
Source: PubMed
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    ABSTRACT: Depression in the elderly is a serious condition, and if not treated effectively, it can increase morbidity and mortality. In addition, it is associated with cognitive impairment and multiple medical problems. Frailty is also associated with depression. Depression in this age group can easily become resistant to the usual treatment, even with adequate medication and or psychotherapy, and it is difficult to achieve remission. It is imperative that other methods to treat depression such as neuromodulation therapies, also known as brain stimulation therapies or techniques, should be used earlier than later in the disease to control effectively the depression and achieve a sense of well being in the elderly. Neuromodulation therapies available at this time are electroconvulsive therapy (ECT), vagus nerve stimulation (VNS), magnetic seizure therapy (MST), and deep brain stimulation (DBS); these are invasive and are not office-based. Noninvasive therapies that are available are repetitive transcranial magnetic stimulation (rTMS) and direct transcranial direct current stimulation (tDCS). Other than ECT, limited data are available for other modes of therapy, but information available to date shows promise in treating this debilitating illness in the elderly.
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    ABSTRACT: O presente artigo é uma revisão do conhecimento atual relativo às terapias somáticas em psiquiatria, com foco em transtornos psiquiátricos resistentes ao tratamento usual. Método: Foi realizada uma pesquisa computadorizada da literatura no Medline utilizando as palavras "eletroconvulsoterapia", "estimulação magnética transcraniana", "terapia magnética convulsiva", "estimulação do nervo vago" e "estimulação cerebral profunda", com todos os termos traduzidos para o idioma inglês. Referências listadas em cada artigo foram também analisadas. Resultados: O desenvolvimento de novos tratamentos psiquiátricos não farmacológicos nas últimas décadas renovou o interesse em terapias somáticas. A despeito de a eletroconvulsoterapia continuar a ser o único tratamento somático com eficácia estabelecida, a estimulação magnética transcraniana, a terapia magnética convulsiva, a estimulação do nervo vago e a estimulação cerebral profunda são potencialmente novas modalidades de tratamento psiquiátrico. Conclusões: Novas modalidades de tratamento ainda padecem de falta de conhecimento cientifico adequado. Entretanto, estratégias somáticas ainda representam uma promessa como formas mais eficazes e seguras de tratamento psiquiá-trico. Descritores: Encefalopatia; Eletroconvulsoterapia; Estimulação magnética transcraniana; Nervo vago; Estimulação encefálica profunda A b s t r a c t Objective: This paper reviews the current knowledge of somatic treatment in psychiatry, with a focus on treatment-resistant psychiatric disorders. Method: A computerized search of the literature was conducted on Medline using the words "electroconvulsive therapy", "transcranial magnetic stimulation", "vagus nerve stimulation", "deep brain stimulation" and "magnetic seizure therapy". References from each paper were also screened. Results: The development of new non-pharmacological psychiatric interventions in the past decades has renewed the clinical and research interest in somatic therapies. Although electroconvulsive therapy remains the only somatic treatment with undisputed efficacy, transcranial magnetic stimulation, magnetic seizure therapy, vagus nerve stimulation and deep brain stimulation all offer potential as novel means of psychiatric treatment. Conclusions: New treatment modalities still have an insufficient body of data. Notwithstanding, biological strategies continue to hold promise as a safer and more effective approach to psychiatric treatment.
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