ArticleWorld journal of psychiatry2021
Hypomanic/manic switch after transcranial magnetic stimulation in mood disorders: A systematic review and meta-analysis.
Article in World journal of psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 18 citations in OpenAlex.
- Repetitive Transcranial Magnetic Stimulation in Major Depressive Disorder: From Bench to Bedside-A Scoping Review of Neurobiological Mechanisms and Clinical Translation.Bioengineering (Basel, Switzerland) · 2026Review
- Efficacy, Effectiveness, and Safety of Transcranial Magnetic Stimulation for Bipolar Depression: A Systematic Review and Meta-Analysis.Biological psychiatry global open science · 2026Article
- Advances of paeoniflorin in depression: the molecular mechanism and formula application.Frontiers in pharmacology · 2025Review
- Neuromodulation Strategies in Lifelong Bipolar Disorder: A Narrative Review.Behavioral sciences (Basel, Switzerland) · 2024Review
- Mania triggered by intermittent theta burst stimulation-A case study.Indian journal of psychiatry · 2023Article
- Investigating the Role of Maintenance TMS Protocols for Major Depression: Systematic Review and Future Perspectives for Personalized Interventions.Journal of personalized medicine · 2023Review
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNowadays there is an increasing use of transcranial magnetic stimulation (TMS) both in neurological and psychiatric fields. After Food and Drug Administration approval of TMS for the therapy of treatment-resistant depression, TMS has been widely used in the context of mood disorders (MD). However, growing reports regarding the possibility of developing hypomanic/manic switch (HMS) have generated concern regarding its use in MDs.
aimTo investigate the actual risk of developing HMS due to TMS in the treatment of MD.
methodsWe led our research on PubMed, Scopus and Web of Science on March 22, 2020, in accordance to the PRISMA guidelines for systematic review. Only double blind/single blind studies, written in English and focused on the TMS treatment of MD, were included. A meta-analysis of repetitive TMS protocol studies including HMS was conducted using RevMan 5.4 software. The assessment of Risk of Bias was done using Cochrane risk of bias tool. This protocol was registered on PROSPERO with the CRD42020175811 code.
resultsTwenty-five studies were included in our meta-analysis: Twenty-one double blind randomized controlled trials (RCT) and four single blind-RCT (no. of subjects involved in active stimulation = 576; no. of subjects involved in sham protocol = 487). The most frequently treated pathology was major depressive episode/major depressive disorder, followed by resistant depression, bipolar depression and other MD. The majority of the studies used a repetitive TMS protocol, and the left dorsolateral prefrontal cortex was the main target area. Side effects were reported in eight studies and HMS (described as greater energy, insomnia, irritability, anxiety, suicidal attempt) in four studies. When comparing active TMS
conclusionApplying the most usual protocols and the appropriate precautionary measures, TMS seems not to be related to HMS development.
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