Transcranial magnetic stimulation can benefit patients with depression, debilitating tinnitus

Three patients who have suffered periodic major depression throughout their adult lives told an audience attending a Loyola Grand Rounds presentation how their lives have been transformed by a new magnetic therapy.

The treatment, called transcranial magnetic stimulation (TMS), sends short pulses of magnetic fields to the brain.

"I feel better now than I have in a very long time," said patient Jannel Jump. "I'm living a life now, rather than hiding from it."

Another patient said TMS brought him out of a depression so severe he couldn't get out of bed.

And a third patient said TMS "has helped me to have a glass-is-half-full outlook. I'm in a much better spot today."

The Food and Drug Administration approved TMS in 2009 for patients who have major depression and have tried and failed at least one antidepressant. The FDA has approved one TMS system, NeuroStar®, made by Neuronetics, said Dr. Murali Rao, MD, DFAPA, FAPM, Chairman of the Department of Psychiatry and Behavioral Neurosciences at Loyola University Chicago Stritch School of Medicine.

The patient reclines in a comfortable padded chair. A magnetic coil, placed next to the left side of the head, sends short pulses of magnetic fields to the surface of the brain. This produces currents that stimulate brain cells. The currents, in turn, affect mood-regulatory circuits deeper in the brain. The resulting changes in the brain appear to be beneficial to patients who suffer depression.

Each treatment lasts 35 to 40 minutes. Patients typically undergo three to five treatments per week for four to six weeks.

The treatments do not require anesthesia or sedation. Afterward, a patient can immediately resume normal activities, including driving. Studies have found that patients do not experience memory loss or seizures. Side effects may include mild headache or tingling in the scalp, mostly during stimulation.

Together, psychotherapy and antidepressants result in complete remission in about one-third of patients who suffer major depression. TMS is a noninvasive treatment option for the other two-thirds of patients, who experience only partial relief from depression or no relief at all, Rao said. He noted that TMS is recommended by the American Psychiatric Association's 2010 Treatment Guidelines.

Rao said treatment reports from 41 TMS treatment centers show that about 33 percent of TMS patients who previously had been treatment-resistant reported their depression had significantly lessened or gone away completely. This success rate is about twice as high as the success rate of patients who have tried three or more antidepressants.
Loyola recently began recruiting for a study on whether TMS can benefit patients who suffer from both depression and debilitating tinnitus (ringing in the ears).