Safe but Expensive Magnetic Treatment offers New Hope for Depression

Lisa Franchi February 25, 2014

Depression is one of the most common and debilitating mental health disorders affecting millions of people worldwide. Worse, nearly a third of those who suffer from this mental illness find no relief from the flood of antidepressants available in the market today.

But here’s the good news – depression patients may find relief from a new but expensive treatment when everything else has failed. This out-patient procedure is called Transcranial magnetic stimulation (TMS) which involves sending magnetic pulses to the part of the brain that becomes sluggish during depression – the prefrontal cortex.

Unlike electroconvulsive therapy, patients don’t need to be sedated in the new treatment. They don’t need muscle paralytics to keep from injuring themselves. And there is no risk of memory loss. TMS is done in a medical office, where the patient sits in what looks like a dental chair. A machine aims an intermittent electromagnetic field at targeted areas of the prefrontal cortex.

Though medications and talk therapy help about half of those diagnosed, for more than 30 per cent, drugs prove ineffective. What’s more, side effects of antidepressants can be severe – ranging from fatigue, stomach and intestinal problems, and headaches, to anxiety, weight gain, difficulty sleeping, and sexual dysfunction.

"We’ve had patients come to us who recognise that they are depressed, but they’re very anti-meds," said psychiatrist Luis Allen, medical director at Florida Hospital’s Centre for Behavioural Health, who considers TMS one of the biggest breakthroughs in treating depression in decades. "For them, they see this as a viable option, and it’s one of the safest."

Scott Farmer, a psychiatrist and medical director of TMS Therapy Clinic of Orlando, Florida, deeply believes that the newer treatment might be a good option.

"We’ve seen a 62 per cent response rate to TMS," Farmer said. "When you consider these are people who have tried everything else, that’s fantastic."

But critics say electroconvulsive therapy has a much higher success rate than TMS, particularly for people severely depressed, though they acknowledge the former comes with much greater risk.

TMS is also expensive. Patients undergo sessions five days a week for four to six weeks at a cost of roughly $7,000 to $12,000 for the entire process.

"The idea that you can come in, get the treatment in 37 minutes and be on your way really makes it ideal for a lot of people," said Dr. Richard Holbert, director of TMS at the University of Florida Health Psychiatric Hospital. "We have nurses, business people, lawyers and doctors come in on their lunch hour, get the treatment and then go about their day. The only roadblock is financial." But if the new treatment would be covered by insurance plans, more people can get access to it.

Furthermore, the treatment is not for everyone. TMS, in extremely rare cases, can trigger seizures. It also can’t be used in patients with non-removable metal, such as an aneurysm clip, in or near their heads. And not everyone will respond. In 2013, a study found that 45 per cent of depression patients who used TMS reported complete remission.