Transcranial magnetic stimulation (TMS) has been appoved by the FDA for use in unipolar depression. Accumulating evidence has shown that TMS can be successfully used in patients with bipolar disorder in both the depressed and manic phases. Varying the treatment location and adjusting pulse parameters is necessary when targetting different phases of bipolar disorder. In this poster, we describe a patient who was in the depressed phase of bipolar disorder who had a partial response to electroconvulsive therapy, then achieved full remission with a modified course of TMS. She was a 77 year old woman who had comorbid cardiac and Parkinson's disease. Previous episodes of depression responded well to ECT, but she experienced severe distress over the procedure, particularly due to the use of anesthesia. Other than slight discomfort at the time of treatment she experienced no side effects from TMS. Subjective and objective ratings scales track improvement during her course of treatment. A description of treatment parameters with graphical representation of her response is included.
Brian Miller, MD