Table 1 Summary of cases
Case | HAM-D score | Medication during rTMS | Psychiatric family history | History of bipolarity | TMS application procedure | Session when hypomania was observed | Hypomania treatment |
|---|---|---|---|---|---|---|---|
I | 27 | Escitalopram 10 mg/day | Grandfather had a psychotic disorder | None | 25 Hz, 1,000 pulses, LDLPFC, 100% MT, one session daily | 9 | Escitalopram stopped. Valproic acid added. Eleven sessions of 1 Hz, 250 pulses, RDLPFC rTMS applied |
II | 24 | Venlafaxine 150 mg/day | None | None | 25 Hz, 1,000 pulses, LDLPFC, 100% MT, one session daily | 14 | Venlafaxine stopped. Valproic acid added. Six sessions of 1 Hz, 250 pulses, RDLPFC rTMS applied |
III | 22 | Fluoxetine 60 mg/day | None | None | 25 Hz, 1,000 pulses, LDLPFC, 100% MT, one session daily | 12 | Fluoxetine stopped. Valproic acid added. Eight sessions of 1 Hz, 250 pulses, RDLPFC rTMS applied |
IV | 26 | Escitalopram 20 mg/day, mirtazapine 30 mg/day | None | None | 25 Hz, 1000 pulses, LDLPFC, 1,00% MT, one session daily | 12 | Escitalopram and mirtazapine stopped. Valproic acid added. Eight sessions of 1 Hz, 250 pulses, RDLPFC rTMS applied |