title: Occurrence of delusions during repetitive transcranial magnetic stimulation (rTMS) in major depression.
abstract: BACKGROUND
  Repetitive transcranial magnetic stimulation (rTMS) has been suggested as a potentially useful treatment for major depression. Nonpsychotic depressed patients appear to have a better outcome than those with psychotic symptoms.
  
  
  METHODS
  We report findings in a patient suffering from recurrent, nonpsychotic major depression (DSM-IV) who had 13 daily sessions of rTMS monotherapy within a 3 week period.
  
  
  RESULTS
  During rTMS treatment, the patient developed recurrent severe delusions, which he had never experienced before. Psychotic symptoms remitted quickly with neuroleptic medication.
  
  
  CONCLUSIONS
  In light of preclinical findings showing increased dopaminergic activity after rTMS treatment, occurrence of psychotic symptoms should be considered a potential side effect of rTMS treatment.
authors.affiliation: Department of Psychiatry, University of Munich, Nussbaumstrasse 7, 80336 Munich, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Zwanzger
authors.forename: Robin
authors.initials: R
authors.lastname: Ella
authors.forename: Martin E
authors.initials: ME
authors.lastname: Keck
authors.forename: Rainer
authors.initials: R
authors.lastname: Rupprecht
authors.forename: Frank
authors.initials: F
authors.lastname: Padberg
mesh_terms: D003702:Delusions / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology*; D003865:Major Depressive Disorder / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D004298:Dopamine / Q000502:physiology; D004599:Electric Stimulation Therapy / Q000009:adverse effects*; D004574:Electromagnetic Fields / Q000009:adverse effects*; D006220:Haloperidol / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000503:physiopathology; D011618:Psychotic Disorders / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology; D012008:Recurrence
chemical_list: D006220:Haloperidol; D004298:Dopamine