For American adults between the ages of 15 and 44, depression is the biggest mental health issue that results in lost work time. First-line therapies for depression, such as antidepressants and psychotherapy, are helpful, although they are not always successful. About two-thirds of patients with depression do not feel better after taking an antidepressant for the first time. Despite two months of depression treatment, these patients will likely still have some symptoms, and other medications have less chance of alleviating their conditions.
For many years, people with treatment-resistant depression were only offered electroconvulsive therapy (ECT), also known as "shock therapy." ECT is still widely utilized nationwide since it is the most potent and effective therapy for this problem. However, ECT's adverse effects on memory and cognition make treatment intolerable for many people with depression. Transcranial magnetic stimulation (TMS) is a relatively new therapeutic option for these patients and many others who have not responded well to medicine and therapy alone.
TMS, or transcranial magnetic stimulation, is a painless way to stimulate the brain. TMS devices are non-invasive and work by administering solid magnetic fields to some brain areas linked to depression. Unlike medicines and ECT, which may have unpleasant side effects, TMS can leave the patient feeling no pain. During and after therapy, headache is the most prevalent adverse effect. Individuals with epilepsy, a history of head trauma, or other severe neurologic issues may not be good candidates for TMS due to the risk of seizures, a rare but severe side effect.
The TMS treatment process has a clinically significant response rate of between 50 and 60 percent for people with depression who have not found relief from medication. A third of these people have complete remission, meaning all their symptoms disappear. Despite the positive nature of the findings, it is essential to remember that they are just temporary. There is a substantial relapse rate, similar to that seen with other therapies for mental disorders. However, most TMS patients continue to feel better for months after treatment ends, with the average duration of the response being slightly over a year. Some patients may want to return for further sessions.
TMS therapy is a comprehensive depression treatment that requires sessions five days a week for a few weeks. Depending on the tool and the established clinical protocol, treatment sessions can last anywhere from 20 to 50 minutes. Patients typically check in with a technician or doctor for a few moments upon arrival before the stimulation process starts.
The technician will use a landmark in the brain called the motor cortex to pinpoint the optimal stimulation intensity and anatomical target. Focusing on this region first, the team will know where in the brain to place the stimulation coil and how hard the ring has to "fire" to get the desired effect. The data then translates using mathematical formulas to locate the dorsolateral prefrontal cortex, the brain target with the most evidence of clinical benefit and a region known to a brain with depression. Just one session can alter the brain's excitability, but patients often do not feel better until the third, fourth, fifth, or even sixth week of treatment.
You can learn more about depression treatment by visiting a psychiatrist for an evaluation. Contact our office to learn more about the treatment or book an appointment to get evaluated.
Request an appointment here: https://nycpsychiatricassociates.com or call NYC Psychiatric Associates at (917) 391-0076 for an appointment in our New York office.
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