Repetitive transcranial magnetic stimulation for depression after colorectal cancer treatment with chemotherapy-induced peripheral neuropathy: A case report.
4 affiliations
- 1Department of Psychiatry Fujita Health University School of Medicine Toyoake Japan.
- 2Department of Development and Education of Clinical Research Fujita Health University School of Medicine Toyoake Japan.
- 3Faculty of Nursing, School of Health Sciences Fujita Health University Toyoake Japan.
- 4Department of Psychiatry Nagoya University Graduate School of Medicine Nagoya Japan.
Abstract
Background
Treatment of depression in patients with cancer requires individualized decision-making considering physical symptoms, drug interactions, adverse effects, treatment burden, and acceptability. We report a patient with persistent depression after colorectal cancer treatment, in whom pharmacotherapy was constrained by insufficient efficacy and tolerability, improvement with modified electroconvulsive therapy (mECT) was temporary, and reintroduction of mECT was difficult. She subsequently received repetitive transcranial magnetic stimulation (rTMS).Case presentation
A woman in her 60s developed depression after emergency surgery for lower gastrointestinal perforation caused by descending colon cancer and later developed chemotherapy-induced peripheral neuropathy (CIPN) after postoperative chemotherapy. Pharmacotherapy produced insufficient improvement. Although 10 mECT sessions led to improvement, symptoms recurred after discharge. Reintroduction of mECT was not possible because of strong fear of the treatment and general anesthesia. She was referred to our hospital and received 27 rTMS sessions without changes in psychotropic medication. Her 17-item Hamilton Depression Rating Scale and Clinical Global Impressions-Severity (CGI-S) scores improved from 19 to 8 and from 4 to 1, respectively, whereas the pain Numerical Rating Scale score remained 8. Behavior and daily functioning also improved. Six months after treatment, limb discomfort persisted, but she could still perform household chores and go out. The referring physician rated the CGI-S score as 1.Conclusion
When pharmacotherapy for depression after cancer treatment is constrained by insufficient efficacy or tolerability, and the benefit of mECT is transient or its reintroduction is difficult, rTMS may be considered as a treatment option.
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BibTeX
@article{esaki2026repetitive,
title = {{Repetitive transcranial magnetic stimulation for depression after colorectal cancer treatment with chemotherapy-induced peripheral neuropathy: A case report.}},
author = {Kosei Esaki and Takeo Saito and Yuki Matsuda and Yueren Zhao and Hiroyuki Kimura and Masashi Ikeda and Tsuyoshi Kitajima and Nakao Iwata},
journal = {PCN reports : psychiatry and clinical neurosciences},
year = {2026},
month = oct,
doi = {10.1002/pcn5.70431},
url = {https://europepmc.org/article/MED/42899122},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Repetitive transcranial magnetic stimulation for depression after colorectal cancer treatment with chemotherapy-induced peripheral neuropathy: A case report.
AU - Kosei Esaki
AU - Takeo Saito
AU - Yuki Matsuda
AU - Yueren Zhao
AU - Hiroyuki Kimura
AU - Masashi Ikeda
AU - Tsuyoshi Kitajima
AU - Nakao Iwata
PY - 2026
DA - 2026/10/19
JO - PCN reports : psychiatry and clinical neurosciences
DO - 10.1002/pcn5.70431
UR - https://europepmc.org/article/MED/42899122
AB - Background Treatment of depression in patients with cancer requires individualized decision-making considering physical symptoms, drug interactions, adverse effects, treatment burden, and acceptability. We report a patient with persistent depression after colorectal cancer treatment, in whom pharmacotherapy was constrained by insufficient efficacy and tolerability, improvement with modified electroconvulsive therapy (mECT) was temporary, and reintroduction of mECT was difficult. She subsequently received repetitive transcranial magnetic stimulation (rTMS).Case presentation A woman in her 60s developed depression after emergency surgery for lower gastrointestinal perforation caused by descending colon cancer and later developed chemotherapy-induced peripheral neuropathy (CIPN) after postoperative chemotherapy. Pharmacotherapy produced insufficient improvement. Although 10 mECT sessions led to improvement, symptoms recurred after discharge. Reintroduction of mECT was not possible because of strong fear of the treatment and general anesthesia. She was referred to our hospital and received 27 rTMS sessions without changes in psychotropic medication. Her 17-item Hamilton Depression Rating Scale and Clinical Global Impressions-Severity (CGI-S) scores improved from 19 to 8 and from 4 to 1, respectively, whereas the pain Numerical Rating Scale score remained 8. Behavior and daily functioning also improved. Six months after treatment, limb discomfort persisted, but she could still perform household chores and go out. The referring physician rated the CGI-S score as 1.Conclusion When pharmacotherapy for depression after cancer treatment is constrained by insufficient efficacy or tolerability, and the benefit of mECT is transient or its reintroduction is difficult, rTMS may be considered as a treatment option.
SN - 2769-2558
ER -