The use of topical lidocaine to reduce pain during repetitive transcranial magnetic stimulation for the treatment of depression

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Repetitive transcranial magnetic stimulation (rTMS) is a form of neurostimulation therapy that was recently approved by the Food and Drug Administration for the treatment of depression. Repetitive transcranial magnetic stimulation is considered noninvasive and relatively safe; however, there have been reports of scalp pain during and at the site of stimulation. This case report documents the use of topical lidocaine to reduce scalp pain during rTMS administration. All patients had a diagnosis of major depressive disorder according to research diagnostic criteria and were washed off antidepressant medications before treatment. Patients were given active rTMS treatment during a masked, open-label, or long-term follow-up treatment schedule. Treatment was delivered to the left dorsolateral prefrontal cortex at 120% of the patient's observed motor threshold. Ten patients received 3000 magnetic pulses per session with an on time of 4 seconds and an off time of 26 seconds. Patients who reported pain during stimulation were given topical lidocaine HCl 2%, which was applied 20 minutes before treatment. Patients reported mixed outcomes of using topical lidocaine to reduce scalp pain during stimulation. Half of the patients reported no significant reduction in pain, whereas the other half indicated a noticeable decrease during rTMS. As a case report, our study has limited results. Given the recent approval of rTMS for the treatment of depression, additional studies are warranted to determine optimal methods of reducing scalp pain.

Original languageEnglish (US)
Pages (from-to)44-47
Number of pages4
JournalJournal of ECT
Volume27
Issue number1
DOIs
StatePublished - Mar 2011

Fingerprint

Transcranial Magnetic Stimulation
Lidocaine
Depression
Pain
Scalp
Therapeutics
Major Depressive Disorder
United States Food and Drug Administration
Prefrontal Cortex
Antidepressive Agents
Appointments and Schedules
Research

Keywords

  • lidocaine
  • major depressive disorder (MDD)
  • neurostimulation
  • repetitive transcranial magnetic stimulation
  • rTMS

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Neuroscience (miscellaneous)

Cite this

@article{adb54244582148d4a68c95bcb1f30e5d,
title = "The use of topical lidocaine to reduce pain during repetitive transcranial magnetic stimulation for the treatment of depression",
abstract = "Repetitive transcranial magnetic stimulation (rTMS) is a form of neurostimulation therapy that was recently approved by the Food and Drug Administration for the treatment of depression. Repetitive transcranial magnetic stimulation is considered noninvasive and relatively safe; however, there have been reports of scalp pain during and at the site of stimulation. This case report documents the use of topical lidocaine to reduce scalp pain during rTMS administration. All patients had a diagnosis of major depressive disorder according to research diagnostic criteria and were washed off antidepressant medications before treatment. Patients were given active rTMS treatment during a masked, open-label, or long-term follow-up treatment schedule. Treatment was delivered to the left dorsolateral prefrontal cortex at 120{\%} of the patient's observed motor threshold. Ten patients received 3000 magnetic pulses per session with an on time of 4 seconds and an off time of 26 seconds. Patients who reported pain during stimulation were given topical lidocaine HCl 2{\%}, which was applied 20 minutes before treatment. Patients reported mixed outcomes of using topical lidocaine to reduce scalp pain during stimulation. Half of the patients reported no significant reduction in pain, whereas the other half indicated a noticeable decrease during rTMS. As a case report, our study has limited results. Given the recent approval of rTMS for the treatment of depression, additional studies are warranted to determine optimal methods of reducing scalp pain.",
keywords = "lidocaine, major depressive disorder (MDD), neurostimulation, repetitive transcranial magnetic stimulation, rTMS",
author = "Kenneth Trevino and McClintock, {Shawn M.} and Husain, {Mustafa M.}",
year = "2011",
month = "3",
doi = "10.1097/YCT.0b013e3181f5581c",
language = "English (US)",
volume = "27",
pages = "44--47",
journal = "Journal of ECT",
issn = "1095-0680",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - The use of topical lidocaine to reduce pain during repetitive transcranial magnetic stimulation for the treatment of depression

AU - Trevino, Kenneth

AU - McClintock, Shawn M.

AU - Husain, Mustafa M.

PY - 2011/3

Y1 - 2011/3

N2 - Repetitive transcranial magnetic stimulation (rTMS) is a form of neurostimulation therapy that was recently approved by the Food and Drug Administration for the treatment of depression. Repetitive transcranial magnetic stimulation is considered noninvasive and relatively safe; however, there have been reports of scalp pain during and at the site of stimulation. This case report documents the use of topical lidocaine to reduce scalp pain during rTMS administration. All patients had a diagnosis of major depressive disorder according to research diagnostic criteria and were washed off antidepressant medications before treatment. Patients were given active rTMS treatment during a masked, open-label, or long-term follow-up treatment schedule. Treatment was delivered to the left dorsolateral prefrontal cortex at 120% of the patient's observed motor threshold. Ten patients received 3000 magnetic pulses per session with an on time of 4 seconds and an off time of 26 seconds. Patients who reported pain during stimulation were given topical lidocaine HCl 2%, which was applied 20 minutes before treatment. Patients reported mixed outcomes of using topical lidocaine to reduce scalp pain during stimulation. Half of the patients reported no significant reduction in pain, whereas the other half indicated a noticeable decrease during rTMS. As a case report, our study has limited results. Given the recent approval of rTMS for the treatment of depression, additional studies are warranted to determine optimal methods of reducing scalp pain.

AB - Repetitive transcranial magnetic stimulation (rTMS) is a form of neurostimulation therapy that was recently approved by the Food and Drug Administration for the treatment of depression. Repetitive transcranial magnetic stimulation is considered noninvasive and relatively safe; however, there have been reports of scalp pain during and at the site of stimulation. This case report documents the use of topical lidocaine to reduce scalp pain during rTMS administration. All patients had a diagnosis of major depressive disorder according to research diagnostic criteria and were washed off antidepressant medications before treatment. Patients were given active rTMS treatment during a masked, open-label, or long-term follow-up treatment schedule. Treatment was delivered to the left dorsolateral prefrontal cortex at 120% of the patient's observed motor threshold. Ten patients received 3000 magnetic pulses per session with an on time of 4 seconds and an off time of 26 seconds. Patients who reported pain during stimulation were given topical lidocaine HCl 2%, which was applied 20 minutes before treatment. Patients reported mixed outcomes of using topical lidocaine to reduce scalp pain during stimulation. Half of the patients reported no significant reduction in pain, whereas the other half indicated a noticeable decrease during rTMS. As a case report, our study has limited results. Given the recent approval of rTMS for the treatment of depression, additional studies are warranted to determine optimal methods of reducing scalp pain.

KW - lidocaine

KW - major depressive disorder (MDD)

KW - neurostimulation

KW - repetitive transcranial magnetic stimulation

KW - rTMS

UR - http://www.scopus.com/inward/record.url?scp=79952193980&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79952193980&partnerID=8YFLogxK

U2 - 10.1097/YCT.0b013e3181f5581c

DO - 10.1097/YCT.0b013e3181f5581c

M3 - Article

C2 - 21233765

AN - SCOPUS:79952193980

VL - 27

SP - 44

EP - 47

JO - Journal of ECT

JF - Journal of ECT

SN - 1095-0680

IS - 1

ER -