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5-Day Brain Stimulation Treatment Shows Promise for Bipolar Disorder

A new form of brain stimulation therapy could dramatically reduce treatment time for people with bipolar disorder. Researchers at the University of Pennsylvania have tested an accelerated version of theta burst stimulation (TBS) that can be completed in just five days, compared to the 4-6 weeks required for standard TBS treatments.

The study, published in JAMA Psychiatry, focused on a technique called accelerated intermittent theta burst stimulation (aiTBS). This non-invasive method uses a changing magnetic field to induce electric currents in specific brain areas, potentially altering brain connectivity and reducing depressive symptoms.

Yvette I. Sheline, MD, lead researcher and Director of the Center for Neuromodulation in Depression and Stress at the University of Pennsylvania, stated: “aiTBS offers a new potential therapy for depressed patients with bipolar disorder who may not respond well to drugs or cannot tolerate their side effects while also significantly shortening the treatment window.”

Promising Results for Bipolar Depression

The study involved 24 patients with treatment-resistant bipolar disorder who were already taking mood stabilizers. Half received active aiTBS treatment, while the others received a sham treatment. Neither the patients nor the researchers knew who was in which group until the study ended.

Patients underwent 10 sessions per day for five days, with each session lasting one hour. Depression symptoms were measured using the Montgomery-Asberg Depression Rating Scale (MADRS) before treatment, one day after, and at a four-week follow-up.

The results were striking. In the active treatment group, the average MADRS score dropped from 30.4 before treatment to 10.5 immediately after. The sham group saw little change, with scores moving from 28.0 to 25.3. This significant decrease in depression symptoms for the active treatment group suggests that aiTBS could be a powerful tool for managing bipolar depression.

A New Option for Difficult-to-Treat Cases

Bipolar disorder is a complex mood disorder characterized by alternating periods of depression and mania or hypomania. While it’s typically treated with mood stabilizers like lithium and sometimes talk therapy, many patients struggle to find effective treatments or suffer from medication side effects.

The FDA has already approved aiTBS for treating major depressive disorder (MDD), but this is the first accelerated trial focusing on bipolar disorder. This distinction is important because bipolar disorder can be more challenging to treat than MDD due to the risk of triggering manic episodes.

Dr. Sheline noted that while the small sample size requires replication in a larger trial, it is comparable to recent studies of aiTBS for MDD. If these results hold up in larger studies, aiTBS could offer a fast-acting alternative for patients who haven’t responded well to other treatments.

The potential of completing treatment in just five days, compared to the weeks or months often required for medication adjustments or traditional TBS, could be a game-changer for many patients. It could mean less time away from work or family obligations and potentially faster relief from debilitating symptoms.

As research continues, this accelerated form of brain stimulation may offer new hope for those struggling with bipolar disorder, providing a quicker path to symptom relief and improved quality of life.


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