Treatment-emergent mania/hypomania during antidepressant treatment with transcranial direct current stimulation (tDCS): a systematic review and meta-analysis

AR Brunoni, AH Moffa, B Sampaio-Júnior, V Galvez… - Brain Stimulation, 2017 - Elsevier
AR Brunoni, AH Moffa, B Sampaio-Júnior, V Galvez, CK Loo
Brain Stimulation, 2017Elsevier
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 …
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.
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