Up to 20 percent of people with depression fail to improve with such therapies as psychotherapy and medications. But psychiatrists now have a new tool that may help these “treatment-resistant” patients—transcranial magnetic stimulation (TMS). The noninvasive therapy involves applying a mild electric current to the scalp to stimulate nerves in the region of the brain that regulate mood.
Studies show TMS worked significantly better in relieving hard-to-treat depression than a placebo treatment that looked and felt similar to the actual TMS treatment. “We had a three-fold increase in remission with active treatment compared to the inactive treatment,” says Mark S. George, M.D., professor of psychiatrist, radiology and neurosciences at the Medical University of South Carolina in Charleston, who has studied the therapy.
In other studies, one in two patients suffering with depression improved significantly with TMS, and one in three patients were completely free of depression symptoms after six weeks of treatment.
How it works: Patients sit in a reclining chair and are given earplugs to wear during the treatment. An electromagnetic coil that emits stimulating pulses is placed against the patient’s head, producing a tapping or clicking sound. Side effects are minimal, although some patients experience minor pain or tingling at the scalp.
But the course of therapy can be inconvenient. Patients have to travel to a doctor’s office or clinic that provides the treatment, which involves about a half hour once a day for several weeks. “The way we’re giving it now is inefficient,” George says. “It’s a lot more bother than reaching into the medicine chest.” Last year, however, a small research study from Emory University in Atlanta suggested that a month’s worth of TMS treatment could be safely and effectively consolidated into a few days.
Insurance coverage is determined on a case-by-case basis, but George expects more treatment to be reimbursed as the therapy becomes more available. The therapy is currently available in about 300 psychiatrists’ offices or clinics nationally and use is growing. Says George, “It’s becoming a part of clinical practice.”
CONNECT THE DOTS
Read more about depression and treatments at the American Psychological Association. To learn more about TMS and other brain-stimulation therapies for depression, go to the National Institutes of Mental Health, or get tips for living with depression. Also check out our blog post on “Deep Brain Stimulation for Depression.”
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