A New Hope for Depression?
Emerging magnet-based therapy can help patients with mild to moderate cases who don’t respond well to medication
Those who suffer from clinical depression have a promising, little-known treatment option to consider.
Transcranial Magnetic Stimulation, an FDA-approved therapy, uses a magnet to create a small electrical current to stimulate the part of the brain implicated in depression. It appears to be most effective for patients with mild to moderate depression who don’t respond well to the physical side effects of medication.
Data indicates up to a 50 percent reduction in symptoms among recipients, and some TMS users have gone off medication entirely.
“This whole area of brain stimulation has just taken off in the last 10 years,” says Dr. Stephan Taylor, a professor of psychiatry at the University of Michigan. “There are all kinds of things people have discovered about delivering electric or magnetic stimulation.”
An application to the FDA is pending to use TMS to treat migraines, and Taylor thinks there’s a good chance it will be used to treat chronic pain, too. Insurers are starting to cover it, making it more broadly available.
TMS requires a patient to don a cap with a magnet inside. The cap is connected to a machine that delivers electricity through the magnet to the targeted area of the brain. To the patient, it feels like tapping on the brain; for some, the sensation is initially uncomfortable (the effect tends to wear off as the number of treatments grows). The 20-minute sessions occur every weekday for at least four weeks, and usually more; the procedure’s demanding schedule is one barrier for some patients.
U-M, which was a clinical site during the FDA trials for TMS about 10 years ago, is conducting a study, funded by the National Institutes of Health, looking at the brain function of patients undergoing the treatment.
Dr. Lila Massoumi, a Farmington Hills-based psychiatrist, began offering TMS in February. She uses a machine that provides deep TMS, in which a deeper area of the brain is stimulated. “The most dramatic improvement I’m seeing is people become sharp,” she says. “When someone is depressed, it can affect your motivation, it can affect your IQ, you can become intellectually blunted. [With TMS], it’s not like a stimulant — there’s sort of this dramatic clarity … and they wake up.”
Patients shouldn’t expect to see an improvement for two to three weeks, she says, though she has noticed positive changes after just a week.
“I believe that the use of TMS in psychiatry is going to grow exponentially,” Massoumi says. “Given the choice, most people would reject taking a medication for the rest of their lives [with all of its side effects], if they knew they could just do a time-limited treatment.”
Indeed, mental illness often bedevils even those proactive about seeking help. Drugs are sometimes ineffective or have side effects. Other times a medication works wonders, only to have its effects wear off over time.
Haley Seaman, 19, of Troy tried TMS after taking various medications to treat her anxiety and depression. “I’d always had anxiety as a child, but the depression came on really suddenly,” Seaman says. “I felt very different and isolated from people. The biggest thing was I really lost motivation for school. I’d always had straight A’s, but I just couldn’t do it. I went to see a counselor, and told her I just felt so weird, and she said, ‘This is depression.’ She put the word to it and it just made so much sense to me.”
Seaman was referred to Massoumi and began taking Prozac in July 2013. The Prozac quickly helped, but after about six months, its effect began to wane. She transitioned to Lamictal.
In fall 2014, however, Seaman spiraled into a serious depression. She was enrolled in college in Ohio, and her mother, Janet, felt scared when she came to pick her up and saw her. “The evolution I saw was a person who was totally depressed, not motivated, had stopped exercising. For me, I just wanted my daughter back.”
When they went to see Massoumi, she suggested TMS as an alternative to trying another medication. Haley and her parents agreed she would try TMS, so Massoumi, who wasn’t yet providing it, referred her for treatment. After a couple of weeks of sessions, Seaman says she was no longer crying daily. She began transitioning off her medication and by Thanksgiving, she says, her mood had improved markedly.
“When we went up north at Christmas, it was just a new beginning for Haley,” Janet Seaman says. “Socially she was able to be in the group and not be so isolated.”
Because TMS is a relatively new treatment, its long-term success isn’t yet known. “There are no really good studies tracking people, but at least half the patients who get a benefit will hold it for a year or two,” Taylor says. “You can get treated again, and some people are getting maintenance TMS, three to four times a month.”
TMS is a “good, important alternative to have,” he adds. “The people I think of being most responsive is people who haven’t spent their whole lives being depressed, who aren’t responding to meds — TMS is going to kick them out of their rut and they’re going to get back to their lives.”
Haley Seaman went back to college and has finished TMS treatments. She also has remained off anti-depressants. “I had never felt genuine anger and sadness until [my depression],” she says. “It was pure frustration. ... I finally got to be me again.”
For those interested in learning more about the University of Michigan’s study on TMS, and for eligibility, visit umclinicalstudies.org or call 800-525-5188.