This issue of Psychiatric Annals, guest edited by Dr. Khurshid A. Khurshid, focuses on which neuromodulation models can be used effectively to treat an array of mental disorders. As defined in this issue, the techniques used to administer some of the newer neuromodulation treatments are less invasive, which may increase patient satisfaction and remission.
The first article, “Overview of the Current Use of Deep Brain Stimulation in Psychiatric Disorders,” by Drs. Daniel P. Witter and Herbert E. Ward reviews the history of deep brain stimulation, which started as a treatment for refractory mood disorders.
The second article, “Update on Transcranial Magnetic Stimulation for Depression and Other Neuropsychiatric Illnesses,” by Drs. Jonathan E. Becker, Christopher Maley, Elizabeth Shultz, and Warren D. Taylor overviews transcranial magnetic stimulation and its use in clinical practice for the treatment of depression and other disorders.
Next, transcranial direct current stimulation (tDCS) is discussed by Sarah M. Szymkowicz, Molly E. McLaren, and Drs. Uma Suryadevara and Adam J. Woods in the article “Transcranial Direct Current Stimulation Use in the Treatment of Neuropsychiatric Disorders: A Brief Review.” The authors review the efficacy of tDCS in depression, while proposing that more in-depth studies are warranted to understand the benefits of this treatment model, as well as other neuromodulation techniques that seek to alleviate the symptoms of psychiatric disorders.
The final article, “Charting the Course of Electroconvulsive Therapy: Where Have We Been and Where Are We Headed?,” by Drs. Peter B. Rosenquist, W. Vaughn McCall, and Nagy Youssef details electroconvulsive therapy (ECT) and what methods are used to select patients who are a best fit for this treatment modality. A recent finding suggests that the medication pramipexole may be an alternative when ECT fails for patients with treatment-refractory depression.1
Although neuromodulation systems are emerging in the psychiatry field, there's still lots of work necessary to balance medication-based therapies with psychotherapeutic methods; the long-term goal is the implementation of more effective holistic treatment modalities for all patients regardless of their disorder.
- Fawcett J, Rush AJ, Vukelich J, et al. Clinical experience with high-dosage pramipexole in patients with treatment-resistant depressive episodes in unipolar and bipolar depression. Am J Psychiatry. 2016;173(2):107–111. doi:10.1176/appi.ajp.2015.15060788 [CrossRef]