High-frequency Repetitive Transcranial Magnetic Stimulation Targeting Left Dorsolateral Prefrontal Cortex for Depression Ameliorates Insomnia yet Triggers Excessive Daytime Sleepiness: A Catch-22 Situation

Jithin T Joseph; Ashok Jammigumpula; Vidyashree S Manibettu; Abhiram N Purohith; Sonia Shenoy; Suma Udupa; Samir Kumar Praharaj

doi:10.1177/02537176241229138

High-frequency Repetitive Transcranial Magnetic Stimulation Targeting Left Dorsolateral Prefrontal Cortex for Depression Ameliorates Insomnia yet Triggers Excessive Daytime Sleepiness: A Catch-22 Situation

Indian J Psychol Med. 2024 Feb 19:02537176241229138. doi: 10.1177/02537176241229138. Online ahead of print.

Authors

Jithin T Joseph¹, Ashok Jammigumpula¹, Vidyashree S Manibettu¹, Abhiram N Purohith¹, Sonia Shenoy¹, Suma Udupa², Samir Kumar Praharaj¹

Affiliations

¹ Clinical Research Centre for Neuromodulation in Psychiatry, Dept. of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
² Dept. of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Abstract

Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain stimulation technique that is effective and safe for the treatment of depression. We observed improvement in insomnia along with symptoms of depression following high-frequency rTMS over the left dorsolateral prefrontal cortex in a patient with treatment-resistant depression, which progressed to excessive daytime sleepiness during the treatment sessions. Causality assessment suggested a probable association of rTMS with excessive sleepiness. The implications of the effect of rTMS on sleep are discussed.

Keywords: depression; excessive daytime sleepiness; insomnia; rTMS.

Publication types

Case Reports