Neurostimulatory, neuromodulatory and neurosurgical treatments in psychiatry

• Autores: Martha Finnegan, Declan McLoughlin
• Localización: Medicine, ISSN-e 1357-3039, Vol. 44, Nº. 12, 2016, págs. 742-744
• Idioma: inglés
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• Resumen

  • Electroconvulsive therapy (ECT) is the most effective treatment for severe depression, with a remission rate of 45–70%. It is recommended for the rapid improvement of treatment-resistant episodes of severe depression, severe or prolonged mania, and catatonia. It is a safe procedure and the major medical risks are related to anaesthesia. Cognitive adverse effects can be distressing but can be minimized by the use of high-dose unilateral ECT; they rarely persist beyond a few weeks after the course of treatment. Repetitive transcranial magnetic stimulation has recently been approved for use in depression but is much less effective than ECT. Other methods of brain stimulation under investigation include transcranial direct current stimulation and deep brain stimulation. Stereotactic neurosurgery is only available in specialized centres under highly regulated conditions, but may be of benefit to some patients.