Switch to Mania After Slow rTMS of the Right Prefrontal Cortex

Letter to the Editor

Sir: Recent evidence indicates that slow repetitive transcranial magnetic stimulation (rTMS) of the right dorsolateral prefrontal cortex (DLPFC) exerts antidepressant effects. Here, we report on 2 patients suffering from a therapy-resistant major depressive episode who had given their written informed consent to participate in a controlled rTMS trial. Both patients underwent 1-Hz rTMS of the right DLPFC and switched from depression to a manic state.