Depression is a serious mental illness that burdens many people at one time or another in their life. It’s estimated that 6.7% of all adults in the United States have depression. This is roughly equal to 16.2 million people. Many new cases of depression are being seen in younger children every year and experts have offered opinions as to why the risk of developing mental health issues is increasing. Most fingers are being pointed at technology and the social media craze. Whatever the case may be, what’s most important is getting treatment and fighting the stigma that often prevents people from seeking the treatment they need. Of course, not everything is that easy, many people who get treated see no signs of recovery. The common response is to up the dosage or switch to a different medication in hopes of finding one that works.
What if I told you there was another option for treatment resistant individuals that involves brain stimulation with magnets. It might sound a little crazy, but it exists and is beginning to gain more traction. The procedure is known as transcranial magnetic stimulation (TMS), and it works by producing magnetic fields around the brain to stimulate nerve cells. An electromagnetic coil is placed around the patient’s head and painlessly administers magnetic pulses. Clinicians from this study reported a response rate of 58.0% and a remission rate of 37.1%. The collection of studies surrounding TMS have shown that it is an effective treatment for individuals who don’t show improvement after taking medications.
So, how does TMS compare against the somewhat similar and more known method electroconvulsive therapy (ECT)? Response rates for ECT are known to be around 70% which is significantly higher than TMS, but the procedure of TMS offers many advantages such as not requiring anesthesia, no resulting problems with memory, and less irritating side effects. Typically, patients start at 5 days a week for 40 minute sessions each day and visits gradually lessen as therapy continues. As expected, the cost for this kind of therapy can be quite expensive at $400 to $500 per session, but coverage by insurance companies is becoming more common as the positive feedback from patients is being heard. Researchers still have a lot more to discover about the inner workings of TMS, but the hope is that it will extend over into other areas of psychiatry.
Posted by Matt Murdoch (3)
Wednesday, October 3, 2018
Combating Treatment Resistant Depression with Magnets?
Posted by Peter Houlihan at 7:49 PM
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This is really interesting and inspiring actually. As someone who struggles with depression and anxiety and feels strongly about advocating for increased mental health research and treatment, new findings and new treatments are really exciting to me. While I don't believe that there should be any stigma against medication for mental health, it isn't always for everyone, so offering alternative treatments can be really beneficial. What is the mechanism in which this treatment actually works? Could this treatment work with medication to potentially increase the effects even more?ReplyDelete
Posted by Jamie Downer
This is the first time i hear about that kind of treatment for depression, thank you for sharing. I was wondering why the TMS is showing good results on patient that already tried medications and did not get good results, it would be better if this technique can be used before even starting medications because psychotic medications have always side effects that are not pleasant. In addition, it is clearly an expensive treatment and insurance would pay for it for sure if that prevents life-long treatments.ReplyDelete
Posted by Jad Imad
You're not wrong in saying that TMS or even ECT could be used as a first line of treatment, but due to the current nature and cost of the treatment, it's highly unlikely and unreasonable for most people. It's unfortunate, but insurance companies will not cover TMS treatments before attempting more common, cost effective methods such as psychotherapy and medications. This is why all the studies only use patients that have tried and failed with medications, but it could always change in the future.Delete
This is also the first time I have heard of this type of treatment! I would be very interested to see if those who were administered this treatment experience its benefits long-term. In other words, how long will they need to continuously get this treatment done before stopping? And if they do stop the treatment, will they remain in remission, or will the stimulated nerve cells eventually return to their previous (depressive) state? Since appointments can be expensive and a bit time-consuming it may be important to look at these factors. Overall, though, I think this has to potential to be an excellent alternative for those who struggle with the current medications.ReplyDelete
Posted by Alexandra Rios
Treatments normally continue for 4-6 weeks depending on how the patient responds. As with most treatments, the study mentions that TMS does have a high recurrence rate, and that the average length of response is around 1 year. Many patients choose to return for another session after this time. This obviously isn't ideal, but hopefully as research continues for both TMS and depression, the answers will slowly unfold and treatments can be adjusted to be more effective.Delete
I have actually heard about TMS before, specifically it can be immensely helpful for people who have found that traditional pharmaceutical medication does nothing to alleviate their depression. As the stigma around mental illness lessens, it is likely that even more people than before will be diagnosed, and a wide array of treatments should be available in order to help treat each unique individual and circumstance. TMS seems to be an up and coming alternative treatment for depression, but I am still curious about the science behind mood improvement due to nerve cell stimulation.ReplyDelete
Posted by Jamie Courtney
The science behind depression and treatments such as TMS seems fascinating and I wish I had more time to gain a deeper understanding, but here's the basics of what I know. When observing the structure/function of the brain in people who experience depression, it's clear that there are many neurodegenerative issues. Neuronal atrophy and a large decrease in the number of synaptic connections are common, especially in the prefrontal cortex and limbic brain regions. TMS counters this by creating a small electric field inside those brain regions. The intensity and frequency can be controlled to cause depolarization and activity of neurons that leads to long term potentiation, or an increase in synaptic strength. Obviously there's a lot more going on and researchers still have a long ways to go before fully understanding it, but hopefully this explanation made sense.Delete
This is a very exciting news. It shows that the TMS technology can provide patients with one possible method that help them fight against depression. And I really hope this kind of treatment will help more patients in the future. Nowadays, we should care more and more about depression and anxiety. And the presence of the new therapeutic methods may save many people from depression.ReplyDelete
Posted by Muchen Liu
How strong is the electromagnet that's being used? I imagine you wouldn't want a super strong magnet around someone's head? Also, though it's limited to the head, is this something that would have an effect for people with pacemakers?ReplyDelete
Posted by Chandler Kupris
I am curious as to how long this treatment has been used. Could it be possible that there are side effects not currently seen? I find it hard to believe that something involving the movement of electrochemical components of the brain could have no serious side effects, even if rare.ReplyDelete
Posted by Lauren Hiller
Along with other people's comments, I am also curious about the side effects and other aspects of this treatment. Would someone who had metal screws, bolts or plates in their body be able to have this as a treatment option?ReplyDelete
Posted by Danielle Bermingham