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    Treatment-emergent mania/hypomania (TEM) is a possible adverse effect of pharmacological and non-pharmacological antidepressant treatments. We performed a systematic review and meta-analysis to evaluate the risk of TEM in depressed patients during randomized, sham-controlled trials (RCTs). Medline database, from the first date available to August 12, 2016. From 283 references, 10 RCTs were identified. Only 3 of them described TEM. In active and sham groups, respectively, only 8 of 226 (3.5%) and 1 of 190 (0.5%) participants presented TEM. This difference was not statistically significant (OR = 1.79, 95% CI = 0.6 to 5.32). There were also five additional reports of TEM in participants not on RCTs. No risk factors for TEM were identified. Low number of studies and TEM reports. Despite previous reports, active vs. sham tDCS was not associated with a significantly greater number of TEM episodes. Copyright © 2016 Elsevier Inc. All rights reserved.


    André R Brunoni, Adriano H Moffa, Bernardo Sampaio-Júnior, Verònica Gálvez, Colleen K Loo. Treatment-emergent mania/hypomania during antidepressant treatment with transcranial direct current stimulation (tDCS): A systematic review and meta-analysis. Brain stimulation. 2017 Mar 01;10(2):260-262

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    PMID: 27916405

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