THURSDAY, Oct. 14 (HealthDay News) -- A treatment for major
depression that uses intense magnetic pulses to stimulate the
brain, previously shown to reduce acute symptoms for brief periods,
appears to work over the longer term when teamed with
antidepressants, researchers report.
"We wanted to address the question of whether the benefit of TMS [transcranial magnetic stimulation] can be sustained over a reasonable time," said study leader Dr. Philip Janicak, a professor of psychiatry at Rush University Medical Center in Chicago. "Based on this trial, the answer is yes."
While the study is too small to be definitive, "it indicates
that we can maintain the benefit of TMS over six months, and do it
safely -- there were no further risks associated with the use of
TMS in combination with antidepressant drugs," said Janicak.
The study was published in the October issue of
Researchers randomly assigned 301 people diagnosed with major
depression to either real or "sham" magnet therapy for six weeks.
The sham treatment felt similar to the real one, but delivered very
little of the pulse intensity of the real treatment.
The 142 people who received and responded to the real therapy
then entered a 21-day transition phase. During this time, they were
tapered off TMS and started on antidepressant medication, a
standard treatment to prevent relapse.
Of those 142 people, 121 (85 percent) completed the transition
phase without relapsing, and 99 agreed to enter a 24-week,
During this six-month period, only 10 of the 99 (10 percent)
relapsed. Of 38 people whose symptoms worsened, requiring
additional TMS sessions, 32 of them (84 percent) improved and
avoided relapse. Altogether, 75 percent maintained full response to
The study provides valuable information, said Tony Tang, an
adjunct professor of psychology at Northwestern University. "We now
know that with two safeguards in place -- one, that TMS responders
are put on maintenance antidepressant medication, and two, they
receive additional TMS treatments if their symptoms worsen -- TMS
can work" for an extended period, he said.
Because depression tends to recur, it is important to consider
any treatment's long-term performance, added Tang. "In that regard,
the best treatment is high-quality CBT [cognitive behavioral
therapy]. CBT works as well as maintenance antidepressant
medications in preventing relapses, but without the side effects
and costs of long-term medication." But if neither CBT nor
antidepressants work, TMS may be an option, he said.
In TMS, an electromagnetic coil placed on the head delivers
brief magnetic pulses through the scalp and into the part of the
brain linked to depression, the left prefrontal cortex. The pulses,
about as strong as those in a standard MRI scan, stimulate the
nerve cells in that region. It's thought that this stimulation
"resets" electrical activity in this region, thereby improving
A study of 190 people with major depression published earlier
this year, which also compared real and sham TMS, found that the
real thing significantly improved major depression in those who
hadn't been helped by antidepressants. In that study, after three
weeks of treatment, 14 percent of people who received real magnet
therapy recovered from their depression, compared to 5 percent of
those who received the sham treatment.
In 2008, the U.S. Food and Drug Administration approved the
first TMS device to treat depression in adults who weren't helped
by at least one antidepressant. Treatments last about 40 minutes
and are given five days a week for four to six weeks. Magnet
therapy can cause mild side effects, including headaches and
discomfort at the coil site.
Some 250 treatment centers around the country offer magnet
therapy. People are either referred by their doctor or are
evaluated by a center to determine their suitability for the
Since TMS isn't typically covered by health insurance, most
people pay out of pocket. Standard treatments cost $7,000 to
$12,000. However, some insurance companies will pay for the
treatment after an internal review, and at least three insurance
groups cover it on a policy-wide basis, said Janicak.
The study was funded by Neuronetics, Inc., which makes the TMS
device used in the study.
There's more on the treatment of depression at the
U.S. National Institute of Mental Health.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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