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Electrical Brain Stimulation to Treat Neurological Disorders
Published in Bahman Zohuri, Patrick J. McDaniel, Electrical Brain Stimulation for the Treatment of Neurological Disorders, 2019
Bahman Zohuri, Patrick J. McDaniel
The rationale for these technologies, their mechanisms of action, and how they are used in clinical practice are described. rTMS and VNS are effective for treatment-resistant depression. DBS is effective for resistant obsessive-compulsive disorder. QEEG can help predict a patient’s response to an antidepressant. All of these technologies continue to be investigated in treatment studies.
Best practices for managing depression and suicide risk in World Trade Center responders and survivors
Published in Archives of Environmental & Occupational Health, 2023
Sandra M. Lowe, Peter T. Haugen, Rebecca Rosen, Aditi S. Werth
Prior treatment response, individual patient characteristics (e.g., co-occurring conditions, cultural factors, social determinants, cognitive status) and patient preference are key factors when deciding on clinical management. First-line treatments include antidepressants, psychotherapy, and the combination of both. If the preferred treatment is psychotherapy, providers should refer to a mental health specialist. Psychiatric consultation is recommended for patients with severe symptoms who have not responded to first-line treatments. Many effective interventions are available for treatment resistant depression: electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), or ketamine, a medication that provides a rapid antidepressant effect and is particularly helpful in patients with suicidal thoughts.17 Lifestyle modification (i.e., exercise, mindfulness practices) may be used as adjunct interventions to support overall physical and emotional health. Using a quantitative measure of depression severity (e.g., PHQ-9) to monitor treatment progress is recommended by most clinical practice guidelines.