Neurostimulatory, neuromodulatory and neurosurgical treatments in psychiatry.

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Jelovac, A
McLoughlin, D.

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2024-07-06

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en

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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 medically safe procedure and the major risks are related to anaesthesia. Cognitive adverse effects can be minimized by using unilateral electrode placement as well as ultrabrief pulse width (0.3 ms) stimuli; the adverse effects usually resolve within a few weeks after the course of treatment. Repetitive transcranial magnetic stimulation has recently been approved by the National Institute for Health and Care Excellence for use in depression but is much less effective than ECT. Other methods of brain stimulation include vagus nerve stimulation, transcranial direct current stimulation and deep brain stimulation. Stereotactic neurosurgery is only available in specialized centres and under highly regulated conditions, but is of benefit to some patients.

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Jelovac, A., & McLoughlin, D. (2024). Neurostimulatory, neuromodulatory and neurosurgical treatments in psychiatry. Medicine.

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