TMS Offers Latest Treatment Option for Depression
You have tried everything. Searching in earnest for a cure for the depression that sidelines you on a daily basis, you have tried multiple medications and various forms of psychotherapy. After experiencing no relief from symptoms, and having to suffer a myriad of nasty side effects from the antidepressants, you feel as if all your efforts have been in vain.
As futile as it seems to expect a cure after experiencing one disappointment after another, there is a new tool in the depression treatment toolbox: Deep transcranial magnetic stimulation, or dTMS. Deep TMS is a breakthrough therapy that offers the latest treatment option for drug-resistant major depressive disorder (MDD).
What is dTMS?
In 2008 the FDA approved the uses of transcranial magnetic stimulation (TMS) to treat MDD for patients who had not found success in the traditional medications and psychotherapy treatments. TMS is a safe, noninvasive therapeutic solution that offers hope to these patients. Deep TMS (“deep” because the magnetic fields can reach up to 6 cm into the brain) uses electromagnetic pulses to target the region of the brain that is responsible for mood regulation, decision-making, and impulse control, the left prefrontal cortex.
The magnetic pulses, which are about the same strength as an MRI, are delivered through the scalp into the brain, where they produce an electrical current. This current stimulates the neurotransmitters that have been functioning at a diminished capacity, helping to balance out important brain chemistry such as dopamine, serotonin, and norepinephrine that regulate mood. This has the result, in many patients, of alleviating the symptoms related to depression—beginning after just the first few sessions.
Is TMS Safe?
TMS is a safe and effective treatment option for stubborn medication-resistant depression. The treatments involve being seated in a comfortable chair and then fitted with a helmet that has a coil embedded within. The treatment will feel like a light tapping sensation on the scalp as the magnetic pulses are delivered through the coil.
Sessions last about 20 minutes and are prescribed for five times per week for 4-6 weeks.
Because there is no sedation required and no medication involved, there are no systemic side effects from dTMS, compared with the metabolic-related side effects associated with antidepressants (weight gain, insomnia, sexual dysfunction, irritability, and nausea to name a few). Side effects from the dTMS treatments are minimal if any. Some reported side effects include irritation at the scalp site, headache, or lightheadedness, and most of these will dissipate after the treatment session, or disappear entirely as the sessions continue.
TMS has been proven to be Highly Effective
There have been many clinical trials conducted on the efficacy of TMS in recent years, beginning in 1995. The encouraging results of recent clinical studies have bolstered the belief in the psychiatric community that TMS offers a sound and safe alternative or adjunct therapy for patients suffering from chronic depression. Although early research demonstrated that TMS was a safe, effective treatment option for treatment-resistant MDD, new research conducted by Linda Carpenter, M.D. out of Brown University offered exciting data showing long-term remission from symptoms.
To assess the long-term efficacy of TMS, the study followed 307 patients with MDD who had not found relief from symptoms using medications and psychotherapy. The outcome of the study revealed that 264 of these patients (62%) achieved significant improvement in their symptoms, with 41% reporting complete remission. Following the patients for 52 weeks (with some concurrent medication use and some TMS used as needed), 68% of the study participants had achieved symptomatic relief, and 45% attained complete remission.
About the Author
Dr. Manish Sheth
Dr. Sheth is Licensed and Board Certified in Psychiatry and Addiction Medicine. He has experience working with patients who have various conditions such as depression, bipolar disorder, OCD, anxiety, ADHD, and various mood disorders. In addition to his work at Achieve TMS, he is the Co-Medical Director at the Tri-City Medical Center Behavioral Health Unit.