Magnetic stimulation effective for treatment-resistant depression

Magnetic stimulation therapy can beat depression when medication and therapy haven’t worked, according to the December issue of Mayo Clinic Health Letter.

The therapy, called transcranial magnetic stimulation (TMS), involves using brief powerful electromagnetic pulses to alter brain activity. The US Food and Drug Administration (FDA) has approved the therapy for patients whose depression hasn’t improved with medications – estimated to be from 10 to 20 percent of those with the illness.

Patients treated with TMS may experience total remission of depression symptoms. A 50 percent improvement in depression symptoms is common.

A typical treatment schedule involves five, one-hour sessions a week for at least three to five weeks. During a session, the patient sits in a reclining chair while the magnetic coil is positioned and activated. Patients remain awake and alert as the coil alters brain activity. No anaesthesia or invasive procedures are used. The benefits gradually emerge over several weeks.

A recent study compared TMS therapy in a group of people who had drug-resistant depression to a matched group of patients who received an inactive placebo form of TMS therapy. After four to six weeks, the TMS group was twice as likely to have remission of depression symptoms as the group receiving the placebo treatment.

While TMS is being used to treat depression at select medical centers, there are still many unknowns. Researchers don’t know how long the benefits might last. The general belief is that most patients who improve with TMS will continue to need some ongoing therapy for depression, whether it’s medication, counseling, additional TMS sessions or some combination of these therapies.

So far, TMS appears safe, although long-term effects – if any – aren’t well-defined. Short-term side effects usually are mild. They can include discomfort at the treatment site during the treatment session, tingling or twitching of the facial muscles during treatment, and headaches during or after treatment. Rarely, seizures can occur during therapy.

(Source: Mayo Clinic: Mayo Clinic Health Letter: January 2010)