Tuesday, October 24, 2006

TO READ: Transcranial Magnetic Stimulation
Numerous friends and acquaintances with mood disorders have had lots of questions about a treatment I've been receiving lately which uses not medicines or electricity, but a magnet. Transcranial magnetic stimulation (TMS, also known as rTMS with "r" for "repetitive) is a relatively new technique now under study for the treatment of both major depression and bipolar depression. TMS is not yet FDA-approved, but I've been fortunate enough to have had several series of experimental treatments for my sudden and severe depressive symptoms, and it has helped me tremendously, with no apparent side effects other than an occasional moderate headache.

TMS involves stimulating the nerve cells in a specific part of the brain with a magnetic field. In my case, this has been accomplished through a very simple procedure. I sit in a chair in a regular office and a psychiatrist holds a plastic "wand" against a specific spot on my head, a little above and in front of my right temple. The wand is wired to a machine that creates a strong, focused magnetic field, and is controlled by a laptop computer. For 60 seconds, I hear a rhythmic clicking sound, one click per second, as pulses of the field stimulate a part of my brain just centimeters below the skull. All I feel is a sensation of someone "knocking" on my head, and occasionally a slight muscle twitch. After a three-minute rest period, I get another 60 seconds of pulses, and I'm done.

Although ECT (electroconvulsive therapy) has worked wonders for me many times in the past, it requires a general anesthetic and, in my case, has led to significant memory loss. TMS avoids both those things. No anesthetic is needed; I can drive myself home and resume normal activities -- or whatever activities the depression allows. The one slight downside is that my TMS regimen requires treatments five days per week for four weeks. A lot of driving to Stanford for me, but well worth it.

About two weeks after starting treatment, I begin to feel my mood improve and my energy return. When we stop after four weeks of treatment, I usually feel about 90% back to baseline. However, I continue to feel improvement for another week or so, which returns me to a healthy, non-depressed state. For me, this state typically lasts three to five months.

While TMS is not a cure, early studies show it helps 25% to 43% of people with depression who have not responded to medication. I know it has helped give me back my life -- with fewer depressed periods and no additional memory impairment, I'm able to work more and take on bigger projects in life than I've been able to do in years.


John said...

Thanks for providing more proof of the exciting alternative treatments that are on the horizon.

Here's info on another approach that aired on 60 minutes

And here's the general cbs help site that may have some good info

genevere said...

Thank you for your interesting site with lots of information about depression. From a very personal perspective, I am also interested in the use of self-expression as an intervention for depression.