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A 46-year-old member asked:

is the method of transcranial magnetic stimulation any good in treating depression?

5 doctor answers13 doctors weighed in
Dr. Lawrence Smith
Clinical Psychology 30 years experience
Mixed results: According to a nimh review, clinical trials studying the effectiveness of repetitive transcranial magnetic stimulation (rtms) have had mixed results. Some studies have found that rtms is more effective in treating patients with major depression. But, other studies have found no difference in response to rtms compared to inactive treatment.
Dr. James Fox
Dr. James Fox commented
Psychiatry 14 years experience
I am not aware of this review. I'd be interested in the citation. The two largest double blind trials (one sham controlled) each showed positive results - that rTMS effectively treated depression. However, the effect size varied across these two studies (O'Reardon and George).
Aug 3, 2012
Dr. Kira Stein
Dr. Kira Stein commented
Psychiatry 24 years experience
Meta-analyses of more recent TMS studies show very strong effect sizes for TMS. Studies that show TMS as not as effective as inactive treatment are generally older studies using TMS protocols that are not as effective as the ones currently in use clinically.
Dec 12, 2012
Dr. Lawrence Smith
Clinical Psychology 30 years experience
Provided original answer
Yes, this is excellent news! Thanks, Dr. Stein!
Dec 12, 2012
Dr. Byron Law-Yone
Psychiatry 55 years experience
Looks promising : Refractory depression is often hard to treat. Tms offers a safe but expensive treatment which can be offered following failure to just one antidepressant. The treatments are usually 5 days a week and go on for 4-5 weeks in the parts of dallas I am familiar with.I wish insurance would cover this more often.
Dr. Kira Stein
Dr. Kira Stein commented
Psychiatry 24 years experience
As TMS and its benefits are becoming more widely known, more & more insurance companies are providing up-front coverage. Anthem Blue Cross, for example, offers coverage for treatment resistant depression in California, New York, Connecticut, Ohio, and other states. MediCare has a policy for TMS in the North East. Some health insurance companies, however, still don't have an established TMS policy, and are more likely to reimburse claims submitted by patients on appeal, instead of up-front or on initial review. This is typical for new and innovative therapies such as TMS.
Dec 12, 2012
Dr. Kira Stein
Psychiatry 24 years experience
Absolutely: Research shows that tms, when used alone without meds, is as effective as a 1st trial of an antidepressant drug, and more effective than trying a 2nd one. Using tms as an add-on to meds can be even more effective. As a psychiatrist who treats patients with tms and medications in los angeles, i feel very comfortable using both, either separately or in combination, depending on patient needs.
Dr. Alan Ali
Dr. Alan Ali answered
Psychiatry 32 years experience
TMS: Yes, more so when used in combination with antidepressants.
Dr. Kira Stein
Dr. Kira Stein commented
Psychiatry 24 years experience
I also like to use morning bright light therapy at the same time as TMS in unipolar depressed patients. Since they are here at my Los Angeles-based TMS center, 5 days a week, I also have my staff help them as needed with physical exercise. Psychotherapy in-between session can also capitalize on the neuroplastic changes stimulated by TMS, so we encourage this as well. As always, comprehensive approach that personalizes treatment seems to work the best.
Dec 12, 2012
Dr. Louis Cady
Psychiatry 32 years experience
Yes: Yes. I believe, particularly after seeing it in our patients, that it is the most potent, best tolerated procedure. In my estimation, it is as effective as electroconvulsive therapy.... You just have to wait a few weeks to a few months after treatment is concluded. It is not as fast, but is remarkably better tolerated with no memory loss. It is also more potent than medications.

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A 48-year-old member asked:

Can you explain the method of transcranial magnetic stimulation in treating depression?

5 doctor answers12 doctors weighed in
Dr. Lawrence Smith
Clinical Psychology 30 years experience
RTMS: Repetitive transcranial magnetic stimulation (rtms) is a brain stimulation treatment that targets a specific spot in the brain. Scientists believe that this specificity may provide an advantage over ECT (which is effective but has mild side effects). A typical rtms session lasts 30 to 60 minutes and does not require anesthesia. Short electromagnetic pulses do the work.

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