Hypomania Risk in Noninvasive Brain Stimulation

Noninvasive brain stimulation, using electromagnetic waves (repetitive transcranial magnetic stimulation (rTMS)) and direct electrical current (transcranial direct current stimulation (tDCS)), is a new frontier in treating psychiatric maladies. While still being developed as viable treatment options, both options have had numerously reported side-effects, with hypomania being a significant concern during investigations. While there has been a relatively rare incidence of hypomania among rTMS/tDCS trials, it still posits an important issue regarding the safety of both treatment modalities. This review studies the reported episodes of hypomania in rTMS and tDCS trials in order to identify any patterns that may cause the same. Such patterns included higher stimulation strengths with long stimulation periods. These factors, if modified, along with an established regimen of screening and prophylaxis against hypomanic risks, may be effective protection against hypomania, as well as to prevent manic episodes.