Meta-Analysis
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatr. Aug 19, 2021; 11(8): 477-490
Published online Aug 19, 2021. doi: 10.5498/wjp.v11.i8.477
Hypomanic/manic switch after transcranial magnetic stimulation in mood disorders: A systematic review and meta-analysis
Andrea Miuli, Gianna Sepede, Gianfranco Stigliano, Alessio Mosca, Francesco Di Carlo, Giacomo d’Andrea, Aliseo Lalli, Maria Chiara Spano, Mauro Pettorruso, Giovanni Martinotti, Massimo di Giannantonio
Andrea Miuli, Gianna Sepede, Gianfranco Stigliano, Alessio Mosca, Francesco Di Carlo, Giacomo d’Andrea, Aliseo Lalli, Mauro Pettorruso, Giovanni Martinotti, Massimo di Giannantonio, Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti, Chieti 66100, Italy
Maria Chiara Spano, Department of Psychiatry Affective Neuropsychiatry, Sahlgrenska University Hospital, Göteborg 40530, Sweden
Giovanni Martinotti, Department of Pharmacy, Clinical Science, University of Hertfordshire, Herts AL10 9AB, Italy
Author contributions: Miuli A, Sepede G, Pettorruso M, Martinotti G and di Giannantonio M designed the research study; Miuli A, Stigliano G, Mosca A, Di Carlo F, d’Andrea G, Lalli A and Spano MC performed the research; Miuli A and Sepede G analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Francesco Di Carlo, MD, Doctor, Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti, ITAB-Via dei Vestini 33, Chieti 66100, Italy. francesco.dic@hotmail.it
Received: February 16, 2021
Peer-review started: February 16, 2021
First decision: March 16, 2021
Revised: March 24, 2021
Accepted: July 20, 2021
Article in press: July 20, 2021
Published online: August 19, 2021
Processing time: 176 Days and 13 Hours
Core Tip

Core Tip: Transcranial magnetic stimulation (TMS) has been widely used in the context of mood disorders. The purpose of this review/meta-analysis was to examine the risk of developing a hypomanic/manic switch (HMS) during active TMS treatment of mood disorders. Twenty-five double blind/single blind studies were included in the quantitative synthesis. When comparing active TMS vs sham treatment, we did not find any significant difference in the risk of developing HMS between conditions. So, we can conclude that, applying the appropriate precautionary measures, TMS seems not to be related to HMS development.