How effective is TMS for Treatment Resistant Major Depression?

Treatment Resistant Major Depression (TRD) is one of the most dreadful conditions that anyone could ever suffer from. TRD is a painful existence devoid of happiness and pleasure. TRD, the most severe grade of depression defined by multiple medication and therapy failures, often becomes a hopeless situation. Quality of life suffers, as do personal relationships. Functional capacity is impaired and progressively declines over time in afflicted individuals. Many people raise the white flag and surrender, believing that chronic depression is their said lot in life. Others want to keep fighting but do not know what to do. After repeated failed treatments, those affected by depression start to fear they are running out of options. Major advances in Psychiatry over the last decade have created new and powerful options for the treatment of TRD. Transcranial Magnetic Stimulation, referred to as “TMS” is the most groundbreaking. TMS has grown in popularity due to the high degree of effectiveness for Treatment Resistant Depression while having very few side effects.

Q: What is TMS?
A: TMS is the acronym for Transcranial Magnetic Stimulation, which is a cutting edge treatment for depression that involves stimulation of brain tissue using electromagnetic pulses. This noninvasive procedure improves symptoms of depression by activating the parts of the brain associated with mood control and
depression. TMS has grown in popularity due to the high degree of effectiveness for Treatment Resistant Depression while having very few side effects and absolutely no circulation of medication in the bloodstream.

Q: When is TMS indicated?
A: TMS is indicated when conventional treatments for Major Depression have not worked. Insurance coverage is typically approved for individuals who have been diagnosed with Major Depression and have failed at least 4 different medication trials. TMS can be used to treat pregnant women suffering from depression,
with the notable advantage of not exposing the unborn child to any potential ill effects from medications. TMS is also an option for individuals who suffer from major depression and do not wish to take medications, even as a first line option.

Q: What is the TMS procedure
like?
A: The process starts with the placement of an electromagnetic coil over the scalp near the forehead. The motor strip, the area of the brain responsible for movement of limbs and muscles, is then mapped out. This is necessary in order to subsequently determine the location of the lateral prefrontal cortex. The actual procedure involves a delivering a sequence of magnetic pulses to the left lateral prefrontal cortex to induce stimulation. The magnetic pulses pass through the
scalp and the skull to reach the target brain tissue. TMS activates the actual neurons by inducing an electrical current in the part of the brain cell called
the axon. This current travels to the nerve cell body and then affects other connecting brain cells. This stimulation ultimately creates the powerful antidepressant
effect.

Q: When was TMS approved
by the FDA?
A: TMS was approved by the FDA for the indication of treatment resistant depression in 2008. Deep TMS, possible with the newer generation of TMS technology, was approved by the FDA for the indication of treatment resistant depression in 2013.

 

Raul J Rodriguez M.D. is the founder,
CEO and Medical Director of the Delray
Center For Healing and the Delray Center
for Brain Science, outpatient Mental
Health Treatment Centers which offer
comprehensive Major Depression treatment
programs that include advanced
treatments such as therapeutic Ketamine
infusions, Transcranial Magnetic
Stimulation (TMS), DBT psychotherapy
and skills training, advanced psychopharmacology,
and holistic treatments.