Although electroconvulsive shock therapy (ECT) remains a successful treatment strategy in medication-resistant bipolar disorder, not all patients respond well. Here, we report on a successful high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) therapy in a highly treatment-resistant bipolar I patient during a mixed episode. This case illustrates that “combative” HF-rTMS therapy could be a safe and valid treatment alternative for refractory bipolar I patients with mixed episodes.

中文翻译：

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ECT 耐药双相 I 型混合发作患者的强化 HF-rTMS 治疗

尽管电休克疗法 (ECT) 仍然是耐药性双相情感障碍的成功治疗策略，但并非所有患者都反应良好。在这里，我们报告了一个成功的高频重复经颅磁刺激 (HF-rTMS) 治疗在混合发作期间对高度难治性双相 I 患者的治疗。这个案例说明，对于混合发作的难治性双相 I 型患者，“战斗性”HF-rTMS 治疗可能是一种安全有效的治疗选择。