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Brain Stimulation May Treat Severe Depression Better Than Meds

TMS scan

Photo credit: Helen Mayberg/Emory University/NIH

Brain Stimulation May Treat Severe Depression Better Than Meds


by Lisa Winter

About 1 in 10 American adults experience depression. Anti-depressant medication is often the first course of action, but about 40% of those with depression are not helped by that approach. A new study from Neuronetics has revealed that Transcranial Magnetic Stimulation (TMS) could be a beneficial option for some who have not been helped by medications. The study results were announced this week at the Annual Meeting of of the American Psychiatric Association by Mark Demitrack, Vice President and Chief Medical Officer of Neuronetics.
TMS works by using targeted magnetic pulses similar to that used in an MRI to stimulate the brain. This stimulation encourages blood flow and activity in the area of the prefrontal cortex responsible for regulating mood. Initial treatments requires five 37-minute-long sessions each week for about 4-6 weeks, with some using monthly maintenance sessions. The cost of the treatment averages out to about $1000 per month, though some insurances may cover a portion of it.
The study compared the TMS Outcome Study and the landmark Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. After the initial phase of treatment, 53 percent of patients experienced a reduction or remission of their depression symptoms, compared to 38 percent from the STAR*D study.
Following the first six weeks, the TMS group was randomized into two: one group receiving monthly maintenance treatments, and one undergoing monthly observations while getting put on a different medication. In the group that received additional treatment, 62.5% continued to see a reduction or elimination in symptoms three months later, compared to the 43.8% in the group that was just observed monthly.
The most common side effect from TCM is mild pain at the treatment site, though most patients only experience those headaches during the first week. Because the treatment is localized instead of systemic (like oral medications), patients are spared from many side effects such as nausea, fatigue, and changes in appetite.Over the last 15 years, about half of the patients who have been treated with TMS have seen a meaningful reduction in their symptoms, while about 35% have gone into remission, Popular Science reports.
As with most studies, there are some points that have invited in criticism. Roughly 90% of all TMS patients continued to take anti-depressant medication during the study. The study was not blind as doctors and participants knew which treatment each patient was receiving. Additionally, the TMS group that received monthly follow-up treatments was not put up against a placebo group, as the other group was receiving an alternative treatment.

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