We demonstrate the feasibility of lowering the seizure threshold using a combined approach of electroconvulsive therapy and transcranial magnetic stimulation. High-frequency transcranial magnetic stimulation of the supplementary motor area shortly before each electroconvulsive treatment session resulted in a reduction of the seizure threshold by half in a male patient with a severe psychotic depressive episode of bipolar affective disorder.
Keywords: Adverse effect; Lowering seizure threshold; RUL ECT; TMS pre-stimulation; Ultra-brief pulse.
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