Magnetic seizure therapy in an adolescent with refractory bipolar depression: a case report

Abstract

Magnetic seizure therapy (MST) has shown efficacy in adult patients with treatment-resistant depression with limited impairment in memory. To date, the use of MST in adolescent depression has not been reported. Here we describe the first successful use of MST in the treatment of an adolescent patient with refractory bipolar depression. This patient received MST in an ongoing open-label study for treatment-resistant major depression. Treatments employed a twin-coil MST apparatus, with the center of each coil placed over the frontal cortex (ie, each coil centered over F3 and F4). MST was applied at 100 Hz and 100% machine output at progressively increasing train durations. Depressive symptoms were assessed using the 24-item Hamilton Depression Rating Scale and cognitive function was assessed with a comprehensive neuropsychological battery. This adolescent patient achieved full remission of clinical symptoms after an acute course of 18 MST treatments and had no apparent cognitive decline, other than some autobiographical memory impairment that may or may not be related to the MST treatment. This case report suggests that MST may be a safe and well tolerated intervention for adolescents with treatment-resistant bipolar depression. Pilot studies to further evaluate the effectiveness and safety of MST in adolescents warrant consideration.

Magnetic seizure therapy: Towards personalized seizure therapy for major depression

“…A case study evaluated MST in an adolescent with refractory bipolar disorder [24]. The patient remitted after 18 MST treatments that were followed by nine maintenance MST treatments over six months.…”

Pharmacological treatment of bipolar disorder.

“…There also have been concerns about potential rTMS treatmentemergent mania/hypomania in the absence of adequate mood stabilizer treatment, suggesting that rTMS monotherapy (or in combination with an antidepressant) should be avoided in BD (Rachid, 2017). Magnetic seizure therapy has also been of interest, but has only case report-level evidence (Noda et al, 2014).…”

Therapeutic Applications of Noninvasive Neuromodulation in Children and Adolescents

“…75 There is a single case report in which the investigators reported full remission of depressive symptoms in an 18-year-old boy with refractory depression in the context of bipolar II disorder following 18 sessions of 100 Hz MST. 76…”