Accelerated Intermittent Theta Burst Stimulation in Late-Life Depression: A Possible Option for Older Depressed Adults in Need of ECT During the COVID-19 Pandemic.
Identifieur interne : 000829 ( Main/Corpus ); précédent : 000828; suivant : 000830Accelerated Intermittent Theta Burst Stimulation in Late-Life Depression: A Possible Option for Older Depressed Adults in Need of ECT During the COVID-19 Pandemic.
Auteurs : Gerasimos N. Konstantinou ; Jonathan Downar ; Zafiris J. Daskalakis ; Daniel M. BlumbergerSource :
- The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry [ 1545-7214 ] ; 2020.
English descriptors
- KwdEn :
- Aged (MeSH), Betacoronavirus (MeSH), Coronavirus Infections (epidemiology), Depressive Disorder, Major (psychology), Depressive Disorder, Major (therapy), Depressive Disorder, Treatment-Resistant (psychology), Depressive Disorder, Treatment-Resistant (therapy), Electroconvulsive Therapy (MeSH), Female (MeSH), Health Services Accessibility (MeSH), Humans (MeSH), Pandemics (MeSH), Patient Health Questionnaire (MeSH), Pneumonia, Viral (epidemiology), Transcranial Magnetic Stimulation (methods), Treatment Outcome (MeSH).
- MESH :
- epidemiology : Coronavirus Infections, Pneumonia, Viral.
- methods : Transcranial Magnetic Stimulation.
- psychology : Depressive Disorder, Major, Depressive Disorder, Treatment-Resistant.
- therapy : Depressive Disorder, Major, Depressive Disorder, Treatment-Resistant.
- Aged, Betacoronavirus, Electroconvulsive Therapy, Female, Health Services Accessibility, Humans, Pandemics, Patient Health Questionnaire, Treatment Outcome.
Abstract
OBJECTIVE
Electroconvulsive therapy (ECT) is an essential psychiatric service with an important role in treating older adults with severe or treatment-resistant depression. During the COVID-19 pandemic, ECT services have be constrained by infection control measures. We report a case of a 66-year-old female patient with a severe major depressive episode who had previously responded to right unilateral ECT and was treated with two modified accelerated intermittent theta-burst stimulation (aiTBS) protocols.
METHODS
The two aiTBS courses consisted of eight daily sessions over five consecutive days, followed by gradual tapering, using 1,800 pulses per session pre-COVID-19 (first course), and 600 pulses per session during the pandemic (second course).
RESULTS
Moderate to severe baseline depressive symptoms reached remission levels after both courses.
CONCLUSION
The 600-pulses aiTBS treatment protocol reported here warrants further study and evaluation, but may be a potential option in cases where older adults with severe depressive symptoms cannot access ECT during the COVID-19 pandemic.
DOI: 10.1016/j.jagp.2020.07.007
PubMed: 32753340
PubMed Central: PMC7362844
Links to Exploration step
pubmed:32753340Le document en format XML
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<author><name sortKey="Konstantinou, Gerasimos N" sort="Konstantinou, Gerasimos N" uniqKey="Konstantinou G" first="Gerasimos N" last="Konstantinou">Gerasimos N. Konstantinou</name>
<affiliation><nlm:affiliation>Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Temerty Centre for Therapeutic Brain Intervention and Campbell Family Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.</nlm:affiliation>
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<author><name sortKey="Downar, Jonathan" sort="Downar, Jonathan" uniqKey="Downar J" first="Jonathan" last="Downar">Jonathan Downar</name>
<affiliation><nlm:affiliation>Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Poul Hansen Depression Centre, Department of Psychiatry, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.</nlm:affiliation>
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<author><name sortKey="Daskalakis, Zafiris J" sort="Daskalakis, Zafiris J" uniqKey="Daskalakis Z" first="Zafiris J" last="Daskalakis">Zafiris J. Daskalakis</name>
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<author><name sortKey="Blumberger, Daniel M" sort="Blumberger, Daniel M" uniqKey="Blumberger D" first="Daniel M" last="Blumberger">Daniel M. Blumberger</name>
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<author><name sortKey="Daskalakis, Zafiris J" sort="Daskalakis, Zafiris J" uniqKey="Daskalakis Z" first="Zafiris J" last="Daskalakis">Zafiris J. Daskalakis</name>
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<term>Depressive Disorder, Major (psychology)</term>
<term>Depressive Disorder, Major (therapy)</term>
<term>Depressive Disorder, Treatment-Resistant (psychology)</term>
<term>Depressive Disorder, Treatment-Resistant (therapy)</term>
<term>Electroconvulsive Therapy (MeSH)</term>
<term>Female (MeSH)</term>
<term>Health Services Accessibility (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Pandemics (MeSH)</term>
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<term>Pneumonia, Viral (epidemiology)</term>
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<front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b>
</p>
<p>Electroconvulsive therapy (ECT) is an essential psychiatric service with an important role in treating older adults with severe or treatment-resistant depression. During the COVID-19 pandemic, ECT services have be constrained by infection control measures. We report a case of a 66-year-old female patient with a severe major depressive episode who had previously responded to right unilateral ECT and was treated with two modified accelerated intermittent theta-burst stimulation (aiTBS) protocols.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>The two aiTBS courses consisted of eight daily sessions over five consecutive days, followed by gradual tapering, using 1,800 pulses per session pre-COVID-19 (first course), and 600 pulses per session during the pandemic (second course).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>Moderate to severe baseline depressive symptoms reached remission levels after both courses.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSION</b>
</p>
<p>The 600-pulses aiTBS treatment protocol reported here warrants further study and evaluation, but may be a potential option in cases where older adults with severe depressive symptoms cannot access ECT during the COVID-19 pandemic.</p>
</div>
</front>
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