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A new study published in the JAMA Psychiatry looked at accelerated intermittent theta-burst stimulation and treatment-refractory bipolar depression.

"This study looks at treatment of severe refractory bipolar depression,” study author Dr. Yvette Sheline told us. “It uses magnetic stimulation called TMS—transcranial magnetic stimulation, which has been used for the past decade to treat depression.”  

The particular kind of stimulation used—intermittent theta burst stimulation (iTBS), uses a special waveform that has been shown more recently to be effective in treating major depression. However, it has not previously been used in a more accelerated form in which patients get treated for five days in a row and then have completed the treatment in five days rather than requiring four to six weeks of treatment.

According to the National Institute of Mental Health, bipolar disorder affected about 5.7 million adults in the United States which represents 2.6% of the population annually. The average age at which symptoms for bipolar disorder begin to appear is 25, however, children can also be diagnosed with bipolar disorder. The disorder isn’t gender biased; both women and men can suffer from it and many diagnosed with bipolar disorder also have a close relative with the disorder.

“Our hypothesis going in was that this treatment –aiTBS—accelerated iTBS would be effective in treating bipolar depression,”  Dr. Sheline told us. “We designed the experiment to compare an active form of treatment to a sham treatment in which patients were randomly assigned to one or the other.”  

This was done in a blinded manner in which neither the investigators nor patients knew who got which assignment. The research team wanted to be sure there was no bias in the results.         

“The results indicate that patients who got active treatment had a significantly greater improvement in their depression scores relative to those who received sham treatment,” Dr. Sheline told us. “Going forward, this treatment needs to be used in larger samples of patients. We hope it can become more widely available so that more patients with refractory bipolar depression can benefit.”