Intensive HF-rTMS treatment in an ECT resistant bipolar I patient with mixed episode

Zeeuws, Dieter; De Rycker, Kim; De Raedt, Rudi; De Beyne, Matthieu; Baeken, Chris; Vanderbruggen, Nathalie

doi:10.1016/j.brs.2010.01.004

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Intensive HF-rTMS treatment in an ECT resistant bipolar I patient with mixed episode

Dieter Zeeuws
- Department of Psychiatry, University Hospital, Free University of Brussels, UZBrussel, Brussels, Belgium
Kim De Rycker
- Department of Psychiatry, University Hospital, Free University of Brussels, UZBrussel, Brussels, Belgium
Rudi De Raedt
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
Matthieu De Beyne
- Department of Psychiatry, University Hospital, Free University of Brussels, UZBrussel, Brussels, Belgium
Chris Baeken
- Department of Psychiatry, University Hospital, Free University of Brussels, UZBrussel, Brussels, Belgium
- Correspondence: Chris Baeken. Department of Psychiatry, University Hospital (UZBrussel), Free University of Brussels (VUB), Laarbeeklaan 101, 1090 Brussels, Belgium.
Nathalie Vanderbruggen
- Department of Psychiatry, University Hospital, Free University of Brussels, UZBrussel, Brussels, Belgium

Received 23 September 2009; received in revised form 14 December 2009; accepted 13 January 2010. published online 11 February 2010.
Uncorrected Proof

Although electroconvulsive shock therapy (ECT) remains a successful treatment strategy in medication-resistant bipolar disorder, not all patients respond well. Here, we report on a successful high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) therapy in a highly treatment-resistant bipolar I patient during a mixed episode. This case illustrates that “combative” HF-rTMS therapy could be a safe and valid treatment alternative for refractory bipolar I patients with mixed episodes.

Keywords: ECT, rTMS, bipolar I disorder, mixed episode, treatment-resistance