Neuromodulation therapies and treatment-resistant depression

Khalid Saad Al-Harbi,1 Naseem Akhtar Qureshi21National Guard Hospital, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 2General Administration for Research and Studies and Mental Health and Social Services, Riyadh, Saudi ArabiaBackground: Patients with treatment-resistant depression (TRD) who sho...

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Autores principales:	Al-Harbi KS, Qureshi NA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/2729e8a73340474c8b12dbf94133a449
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spelling	oai:doaj.org-article:2729e8a73340474c8b12dbf94133a4492021-12-02T06:35:53ZNeuromodulation therapies and treatment-resistant depression1179-1470https://doaj.org/article/2729e8a73340474c8b12dbf94133a4492012-07-01T00:00:00Zhttp://www.dovepress.com/neuromodulation-therapies-and-treatment-resistant-depression-a10395https://doaj.org/toc/1179-1470Khalid Saad Al-Harbi,1 Naseem Akhtar Qureshi21National Guard Hospital, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 2General Administration for Research and Studies and Mental Health and Social Services, Riyadh, Saudi ArabiaBackground: Patients with treatment-resistant depression (TRD) who showed partial response to pharmacological and psychotherapeutic interventions need a trial of neuromodulation therapies (NTs).Objective: This paper aims to review evidence-based data on the use of NTs in TRD.Method: Using keywords and combined-word strategy, multiple computer searches of PubMed, Google Scholar, Quertle(R), and Medline were conducted for retrieving relevant articles published in English-language peer-reviewed journals (2000&ndash;2012). Those papers that addressed NTs in TRD were retained for extensive review.Results: Despite methodological challenges, a range of 30%&ndash;93% of TRD patients showed substantial improvement to one of the NTs. One hundred&ndash;percent improvement was reported in two single-case studies on deep brain stimulation. Some studies reported no benefits from transcranial direct current stimulation. NTs were reported to have good clinical efficacy, better safety margin, and benign side-effect profile. Data are limited regarding randomized clinical trials, long-term efficacy, and cost-effectiveness of these approaches. Both modified electroconvulsive therapy and magnetic seizure therapy were associated with reversible but disturbing neurocognitive adverse effects. Besides clinical utility, NTs including approaches on the horizon may unlock the biological basis underlying mood disorders including TRD.Conclusion: NTs are promising in patients with TRD, as the majority of them show good clinical response measured by standardized depression scales. NTs need further technological refinements and optimization together with continuing well-designed studies that recruit larger numbers of participants with TRD.Keywords: treatment-resistant depression, neuromodulation therapies, modified electroconvulsive therapy, deep brain stimulation, transcranial direct current stimulation, magnetic seizure therapyAl-Harbi KSQureshi NADove Medical PressarticleMedical technologyR855-855.5ENMedical Devices: Evidence and Research, Vol 2012, Iss default, Pp 53-65 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medical technology R855-855.5
spellingShingle	Medical technology R855-855.5 Al-Harbi KS Qureshi NA Neuromodulation therapies and treatment-resistant depression
description	Khalid Saad Al-Harbi,1 Naseem Akhtar Qureshi21National Guard Hospital, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 2General Administration for Research and Studies and Mental Health and Social Services, Riyadh, Saudi ArabiaBackground: Patients with treatment-resistant depression (TRD) who showed partial response to pharmacological and psychotherapeutic interventions need a trial of neuromodulation therapies (NTs).Objective: This paper aims to review evidence-based data on the use of NTs in TRD.Method: Using keywords and combined-word strategy, multiple computer searches of PubMed, Google Scholar, Quertle(R), and Medline were conducted for retrieving relevant articles published in English-language peer-reviewed journals (2000&ndash;2012). Those papers that addressed NTs in TRD were retained for extensive review.Results: Despite methodological challenges, a range of 30%&ndash;93% of TRD patients showed substantial improvement to one of the NTs. One hundred&ndash;percent improvement was reported in two single-case studies on deep brain stimulation. Some studies reported no benefits from transcranial direct current stimulation. NTs were reported to have good clinical efficacy, better safety margin, and benign side-effect profile. Data are limited regarding randomized clinical trials, long-term efficacy, and cost-effectiveness of these approaches. Both modified electroconvulsive therapy and magnetic seizure therapy were associated with reversible but disturbing neurocognitive adverse effects. Besides clinical utility, NTs including approaches on the horizon may unlock the biological basis underlying mood disorders including TRD.Conclusion: NTs are promising in patients with TRD, as the majority of them show good clinical response measured by standardized depression scales. NTs need further technological refinements and optimization together with continuing well-designed studies that recruit larger numbers of participants with TRD.Keywords: treatment-resistant depression, neuromodulation therapies, modified electroconvulsive therapy, deep brain stimulation, transcranial direct current stimulation, magnetic seizure therapy
format	article
author	Al-Harbi KS Qureshi NA
author_facet	Al-Harbi KS Qureshi NA
author_sort	Al-Harbi KS
title	Neuromodulation therapies and treatment-resistant depression
title_short	Neuromodulation therapies and treatment-resistant depression
title_full	Neuromodulation therapies and treatment-resistant depression
title_fullStr	Neuromodulation therapies and treatment-resistant depression
title_full_unstemmed	Neuromodulation therapies and treatment-resistant depression
title_sort	neuromodulation therapies and treatment-resistant depression
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/2729e8a73340474c8b12dbf94133a449
work_keys_str_mv	AT alharbiks neuromodulationtherapiesandtreatmentresistantdepression AT qureshina neuromodulationtherapiesandtreatmentresistantdepression
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Neuromodulation therapies and treatment-resistant depression

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