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Occurrence of delusions during repetitive transcranial magnetic stimulation (rTMS) in major depression
Peter Zwanzger1, Robin Ella, Martin E Keck
1Department of Psychiatry, University of Munich, Nussbaumstrasse 7, 80336 Munich, Germany.
Background:
Repetitive transcranial magnetic stimulation (rTMS) has been suggested as a potentially useful treatment for major depression. Nonpsychotic depressed patients appear to have a better outcome than those with psychotic symptoms.
Methods:
We report findings in a patient suffering from recurrent, nonpsychotic major depression (DSM-IV) who had 13 daily sessions of rTMS monotherapy within a 3 week period.
Results:
During rTMS treatment, the patient developed recurrent severe delusions, which he had never experienced before. Psychotic symptoms remitted quickly with neuroleptic medication.
Conclusions:
In light of preclinical findings showing increased dopaminergic activity after rTMS treatment, occurrence of psychotic symptoms should be considered a potential side effect of rTMS treatment.