title: A negative double-blind controlled trial of sequential bilateral rTMS in the treatment of bipolar depression.
abstract: To explore the therapeutic benefit of sequential bilateral repetitive transcranial magnetic stimulation (rTMS) in the treatment of bipolar depression.
  
  
  
  A 2 arm randomized controlled parallel design trial comparing the use of active sequential bilateral rTMS to a sham form of stimulation in 49 patients with bipolar disorder and treatment resistant depression.
  
  
  
  There was no significant difference in mean reduction in depression rating scale scores or response rates between active and sham stimulation.
  
  
  
  The study was of limited sample size and the use of bilateral rTMS limited generalizability to other forms of rTMS.
  
  
  
  This study provides no support to the use of active sequential bilateral rTMS in the treatment of the depressive phase of bipolar affective disorder. Although this result is not definitive, we suggest that future research may be better focused on trials evaluating the use of unilateral types of rTMS.
authors.affiliation: Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, St Kilda Road, Melbourne, Victoria 3004, Australia. Electronic address: paul.fitzgerald@monash.edu.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Fitzgerald
authors.affiliation: Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, St Kilda Road, Melbourne, Victoria 3004, Australia.
authors.forename: Kate E
authors.initials: KE
authors.lastname: Hoy
authors.affiliation: Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, St Kilda Road, Melbourne, Victoria 3004, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Elliot
authors.affiliation: Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, St Kilda Road, Melbourne, Victoria 3004, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: McQueen
authors.affiliation: Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, St Kilda Road, Melbourne, Victoria 3004, Australia.
authors.forename: Lenore E
authors.initials: LE
authors.lastname: Wambeek
authors.affiliation: Temerty Centre for Therapeutic Brain Intervention and the Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Zafiris J
authors.initials: ZJ
authors.lastname: Daskalakis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000628:therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Bipolar disorder; Depression; Prefrontal cortex; Remission; Repetitive Transcranial magnetic stimulation; Response