André R Brunoni1, Adriano H Moffa2, Bernardo Sampaio-Júnior3, Verònica Gálvez4, Colleen K Loo5. 1. Service of Interdisciplinary Neuromodulation, Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil; Interdisciplinary Center for Applied Neuromodulation, University Hospital, University of São Paulo, São Paulo, Brazil. Electronic address: brunoni@usp.br. 2. Interdisciplinary Center for Applied Neuromodulation, University Hospital, University of São Paulo, São Paulo, Brazil. 3. Service of Interdisciplinary Neuromodulation, Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil; Interdisciplinary Center for Applied Neuromodulation, University Hospital, University of São Paulo, São Paulo, Brazil. 4. School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, Australia. 5. School of Psychiatry, University of New South Wales, Black Dog Institute, Sydney, Australia; St George Hospital, Sydney, Australia.
Abstract
BACKGROUND: Treatment-emergent mania/hypomania (TEM) is a possible adverse effect of pharmacological and non-pharmacological antidepressant treatments. OBJECTIVE: We performed a systematic review and meta-analysis to evaluate the risk of TEM in depressed patients during randomized, sham-controlled trials (RCTs). DATA SOURCES: Medline database, from the first date available to August 12, 2016. RESULTS: From 283 references, 10 RCTs were identified. Only 3 of them described TEM. In active and sham groups, respectively, only 8 of 226 (3.5%) and 1 of 190 (0.5%) participants presented TEM. This difference was not statistically significant (OR = 1.79, 95% CI = 0.6 to 5.32). There were also five additional reports of TEM in participants not on RCTs. No risk factors for TEM were identified. LIMITATIONS: Low number of studies and TEM reports. CONCLUSION: Despite previous reports, active vs. sham tDCS was not associated with a significantly greater number of TEM episodes. Copyright Â
BACKGROUND: Treatment-emergent mania/hypomania (TEM) is a possible adverse effect of pharmacological and non-pharmacological antidepressant treatments. OBJECTIVE: We performed a systematic review and meta-analysis to evaluate the risk of TEM in depressedpatients during randomized, sham-controlled trials (RCTs). DATA SOURCES: Medline database, from the first date available to August 12, 2016. RESULTS: From 283 references, 10 RCTs were identified. Only 3 of them described TEM. In active and sham groups, respectively, only 8 of 226 (3.5%) and 1 of 190 (0.5%) participants presented TEM. This difference was not statistically significant (OR = 1.79, 95% CI = 0.6 to 5.32). There were also five additional reports of TEM in participants not on RCTs. No risk factors for TEM were identified. LIMITATIONS: Low number of studies and TEM reports. CONCLUSION: Despite previous reports, active vs. sham tDCS was not associated with a significantly greater number of TEM episodes. Copyright Â
Authors: A Antal; I Alekseichuk; M Bikson; J Brockmöller; A R Brunoni; R Chen; L G Cohen; G Dowthwaite; J Ellrich; A Flöel; F Fregni; M S George; R Hamilton; J Haueisen; C S Herrmann; F C Hummel; J P Lefaucheur; D Liebetanz; C K Loo; C D McCaig; C Miniussi; P C Miranda; V Moliadze; M A Nitsche; R Nowak; F Padberg; A Pascual-Leone; W Poppendieck; A Priori; S Rossi; P M Rossini; J Rothwell; M A Rueger; G Ruffini; K Schellhorn; H R Siebner; Y Ugawa; A Wexler; U Ziemann; M Hallett; W Paulus Journal: Clin Neurophysiol Date: 2017-06-19 Impact factor: 3.708
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