TY - JOUR
T1 - The emerging role for repetitive transcranial magnetic stimulation in optimizing the treatment of adolescent depression
AU - Croarkin, Paul E.
AU - Wall, Christopher A.
AU - McClintock, Shawn M.
AU - Kozel, Frank Andrew
AU - Husain, Mustafa M.
AU - Sampson, Shirlene M.
PY - 2010/12
Y1 - 2010/12
N2 - 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.
AB - 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.
KW - adolescents
KW - major depressive disorder
KW - transcranial magnetic stimulation
UR - http://www.scopus.com/inward/record.url?scp=78650512366&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=78650512366&partnerID=8YFLogxK
U2 - 10.1097/YCT.0b013e3181dd17eb
DO - 10.1097/YCT.0b013e3181dd17eb
M3 - Review article
C2 - 20418774
AN - SCOPUS:78650512366
SN - 1095-0680
VL - 26
SP - 323
EP - 329
JO - Journal of ECT
JF - Journal of ECT
IS - 4
ER -