Neuromodulation Therapies

Noninvasive brain stimulation (NiBS) techniques or therapeutic brain stimulation and modulation modalities (TBSM) have the potential to become first-line treatment options for depressive disorders and other common psychiatric conditions in geriatric patients. This chapter discusses their advantages and how these are consistent with an age-adjusted approach. NiBS and TBSM can minimize polypharmacy in treatment-resistant geriatric patients, provide an alternative for patients who cannot tolerate medications, or offer treatment to those who do not engage in psychotherapies. The non-pharmacological therapies discussed here include transcranial magnetic stimulation (rTMS), electroconvulsive therapy (ECT), magnetic seizure therapy (MST), and transcranial direct current stimulation (tDCS). The psychotomimetics ketamine and esketamine therapies are also reviewed.