Effectiveness in Depression
TMS is an established antidepressant treatment
TMS is a novel, medication-free treatment for major depression. The use of TMS as an antidepressant is well established having been FDA approved in 2008 and recommended as a second line option by the American Psychiatric Association. In fact, the strength of the data supporting the antidepressant effects of TMS may be stronger than the support for the effectiveness of medications or therapy. There have been 50 clinical studies with TMS conducted at leading universities such as Columbia, Harvard, Duke and Yale.
TMS is a paradigm shift in antidepressant therapy
Conventional medications and electric shock therapy (ECT) that have been used to treat depression for the past 70-years are highly non-specific in action and influence the whole brain and body. The result is an extremely slow onset of therapeutic effects and a large fraction of non-responders to treatments. In addition, patients have numerous side effects.
Over the past 20-years the circuits involved in depression have finally been discovered. The left front region of the brain (left DLPFC), which is involved in enjoyment and motivation, is under active in all patients with depression and stimulating this area is important for treating depression. TMS therapy involves repeatedly stimulating the left DLPFC until the activity of the region becomes self-sustained through a process called brain plasticity. Thus, TMS is the first treatment in the history of psychiatry that can directly normalize the circuits involved in depression.
The unique and paradigm shifting mechanism of TMS results make it far more effective than conventional treatments and produce complete remission of symptoms in just a few weeks in patients who have failed to respond to several years of medication trials.
Since TMS effects are self-sustained through brain plasticity, the therapeutic benefits are long lasting (after just 4-6 weeks of treatments) in contrast to medications, which need to be taken indefinitely.
Since TMS is specific and non-invasive it has very few side effects and offers hope to people who are sensitive to medications.
It is also one of the safest treatments in psychiatry even in children and pregnant women.
Please see the Treatment Algorithm for an effective illustration of the use of NeuroStar TMS Therapy early on in the treatment of depression
The Benefits of TMS are Durable
Net incidence of relapse 6 months after successful treatment is just 11%. In comparison, 6 month relapse with antidepressant treatment alone in STAR*D study is as high as 65%. Therefore, the benefits of TMS are about 6 times more durable than medications.
Our Outcomes in Depression - 150 patients
Distribution of Response:
- 57% Patients had Hamilton Depression scores
- 22% Patients had 50% decrease in Hamilton D scores indicating 'Response' (significant improvement)
- 20% Patients were 'Non-responders' (no significant improvement)
One of the benefits of TMS is that it is highly durable. Unlike medications or ECT, the effects of TMS are durable and sustained. Only 10% of patients that responded to TMS relapsed within 6-months. For more information, see the attached paper on the durability of TMS.