• Vijay Pathak, Vinod Kumar Sinha, and Samir Kumar Praharaj.
• Department of Psychiatry, Max Hospital, New Delhi, India.
• Clin Psychopharmacol Neurosci. 2015 Dec 31; 13 (3): 245-9.

ObjectiveTo examine the efficacy of adjunctive right prefrontal high-frequency repetitive transcranial magnetic stimulation (rTMS) treatment in adolescent mania patients as compared to sham stimulation.MethodsTwenty six right handed patients aged 12-17 years diagnosed with bipolar mania were randomized to receive daily sessions of active or sham rTMS (20 Hz, 110% of motor threshold, 20 trains, 10 s intertrain interval) over the right dorsolateral prefrontal cortex for 10 days. Mania was rated using Young Mania Rating Scale (YMRS) and Clinical Global Impression (CGI) at baseline, and after 5th and 10th rTMS.ResultsFor YMRS scores, repeated measures analysis of variance (ANOVA) showed a significant main effect (F=44.49, degree of freedom [df]=1.2/29.29, p<0.001, Greenhouse-Geisser corrected, effect size η(2)=0.65), but the interaction effect was not significant (F=0.03, df=1.2/29.29, p=0.912, Greenhouse-Geisser corrected). For CGI-Severity, repeated measures ANOVA showed a significant main effect (F=24.49, df=1.42/34.21, p<0.001, Greenhouse-Geisser corrected, effect size η(2)=0.51), but the interaction effect was not significant (F=0.06, df=1.2/29.29, p=0.881, Greenhouse-Geisser corrected).ConclusionHigh-frequency right prefrontal rTMS was found to be ineffective as add-on to standard pharmacotherapy in adolescent mania.

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