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Trial Testing Magnetic Waves for Bipolar Depression

Sad, depressed

(Daniel Reche, Pixabay)

24 Nov. 2020. Researchers are enrolling patients in a clinical trial testing magnetic waves to induce small seizures as a treatment for depression from bipolar disorder. The study, at University of Texas Health Science Center in Houston, seeks to find if magnetic seizure therapy works as well as electroconvulsive therapy, a currently available treatment for uncontrolled bipolar depression.

Bipolar disorder is characterized by sharp mood swings from high-energy euphoria to deep feelings of sadness, sometimes so severe they require hospitalization, if moods generate dangerous or suicidal behavior. Periods of bipolar disorder, which used to be called manic-depression, can last from days or weeks at a time, over periods of years. Treatments can include drugs and counseling, combined with substance abuse treatments, if needed. About one percent of the U.S. population, or 2.3 million individuals are estimated to suffer from bipolar disorder.

Electroconvulsive therapy is a treatment for bipolar depression and other mental disorders in patients that do not respond to other treatments. This treatment, conducted under general anesthesia, sends small electric currents through the skull to induce brief seizures that change the brain’s chemistry to reverse symptoms of psychiatric diseases. While considered a generally safe treatment, some patients experience adverse effects including memory loss and confusion, as well as some physical effects.

Magnetic seizure therapy also seeks to induce brief seizures in patients with uncontrolled bipolar depression, but instead of an electrical current, the treatments use magnetic waves. Strong alternating magnetic field pulses are sent into the brain from a magnetic coil to induce a seizure in specific regions of the brain responsible for depressive symptoms. The treatments aim to increase blood flow in the targeted regions, while limiting exposure to surrounding brain tissue, to reduce adverse cognitive effects.

Salih Selek, professor of psychiatry and behavioral science at UT Health leads the trial. “In this trial, we’ll use a different machine that uses magnetic waves, not electricity, to induce seizures,” says Selek in a UT Health statement. “So instead of sending an electric signal to the brain, it sends magnetic waves to the frontal parietal lobe of the brain, which helps control emotions.”

The clinical trial is enrolling 60 adult patients with bipolar disorder experiencing depression, and who need a rapid response due to their psychiatric or medical condition. Participants are randomly assigned to receive magnetic seizure therapy or electroconvulsive therapy. Both treatments are given under anesthesia two to three times a week, for up to 15 sessions.

The main efficacy measure in the trial is the number of participants achieving remission, based on a standard scale of adult depression symptoms. The study team is also looking for evidence of cognitive impairment among patients, based on another standard rating scale.

Selek notes that the Covid-19 pandemic is increasing stress and depression, making the need for new treatments more urgent. “Sometimes depression in bipolar patients can lead to suicide attempts,” says Selek, “so it is critically important for us to know the best way to treat bipolar depression in patients who’ve already tried all other treatments.”

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