The Complexity of Deep Brain Stimulation and Suicidality in Patients with Treatment Resistant Depression

摘要

Deep brain stimulation (DBS) has completely changed the field of movement disorders, given its efficacious results in treating patients with Parkinson's disease (PD), dystonia, and essential tremor. Such dramatic results draw attention to its potential use in other neuropsychiatric illnesses, most notably obsessive-compulsive disorder and treatment resistant depression (TRD). Further support of the possible effects of DBS on TRD came from the many reports of mood symptoms that were elicited via direct stimulation. However, these reports carried the caveat that depressive moods and possibly suicidality could be provoked by DBS. Gilbert's article (2013) in this issue considers the ethical implications of this potential adverse effect in TRD patients who are treated with DBS. Although his overall aim to ensure that no undue harm comes to these patients is justifiable, there is concern that the complexity of the situation is lost within his discussion.