At Long Last: A Non-Medicinal Approach to Depression…Right Here at AFP!

In just a couple of weeks, Atkinson Family Practice is going to be the home of an exciting new alternative treatment for individuals with depression called TMS! TMS stands for Transcranial Magnetic Stimulation, and is the first and only FDA-approved treatment for depression that does not require surgery or medication, and is safe and effective. When medication management becomes too much, side effects overwhelming, or non-traditional approaches exhausted, individuals coping with depression may have an answer at last.

tms-therapy-diagram (1)According to John Hopkins, TMS is a, “non-invasive method of brain stimulation that relies on electromagnetic induction using an insulated coil over the scalp, focused on an area of the brain thought to play a role in mood regulation.” It is comparable to MRI machines in terms of the strength and pulse of the waves it generates. The rapid succession of the pulses produces
lasting, healthful results in brain activity. In some cases, TMS has shown long-lasting, favorable results, and could be a long sought-after solution.

What Happens During a TMS treatment?

The treatment is simple. You sit in an armchair similar to that of a dentist’s for about 40 minutes a day, 5 days a week, for 4-6 weeks. The machine produces loud constant clicks (like an MRI machine), so ear plugs are generally given to provide more comfort. Several measurements are recorded to make sure everything will go smoothly, and the TMS coil is suspended over the scalp. The patient’s motor threshold-or minimum amount of power needed for the thumb to twitch-is measured through several short pulses, and is unique to each individual. Working with the motor threshold helps the physician cater treatment specific to the patient.

After the motor threshold is established, the coil is brought to the front of the head so it rests in front of the region that needs stimulating. Patients are awake and alert throughout the entire session, and can go back to normal activities immediately afterwards. The only TMS compressedsensation felt is a series of clicking sounds and a light tapping under the coil.

What Are the Side Effects of TMS?

According to the Eastern Virginia Medical School, commonly reported side effects include scalp discomfort, headaches, and neck pain. Combining TMS with Wellbutrin has also been shown to result in tinnitus, or ringing in the ears. Physicians must be notified of any other medications currently being taken as combining the treatment with certain drugs could result in seizures.  There is no evidence of TMS causing brain tumors – it’s important to remember TMS uses the same strength and type of magnetic fields as MRIs! This process is routinely monitored for negative impacts on memory and concentration, and continually has shown to have no effect. In the clinical studies, Neurostar examined over 10,000 patients, and these were the conclusions:

  • No systemic side effects, such as weight fluctuation, sexual dysfunction, sedation, nausea, or dry mouth
  • Scalp pain/discomfort in the treatment area while the treatment was being performed, with pain ranging from mild to moderate. This side effect declined drastically after one week of treatment.
  • While the risk of seizure is small.
  • Less than 5% of the participants chose to stop the procedure.
  • Individuals with any sort of non-removable metal in head CANNOT get TMS because it is a magnetic based treatment. This includes:
    • Aneurysm clips and coils
    • Stents in neck or brain
    • Implanted stimulators
    • Cardiac pacemakers
    • Electrodes to monitor brain activity
    • Metallic implants in ears and eyes
    • Shrapnel and bullet fragments in neck/head
    • Facial tattoos with metallic or metallic sensitive ink
    • Other metal devices or objects implanted on/near head

A complete list of metals that would impede the treatment process can be found here.

Are There Long Term Consequences?

  • Since TMS is comparable to MRIs and tens of thousands of people have successfully lived and loved having had MRIs, it is believed that there are  likely  no long term consequences. The full course of TMS is only a small fraction of one total brain scan with an MRI.
  • Multiple courses of TMS would be the equivalent of less than a few exposures from MRI.
  • Longer term effects of Neurostar’s TMS are ultimately unkown. Experimental and observational scientific evidence can fairly confidently conclude the Neurostar TMS System Coil presents no significant risk of long-term effects.

Is TMS Right for Me?

So, you have no metal in your head, you’re confident in the extensive study completed by Neurostar and vetted by major research institutions as well as the providers at Atkinson Family Practice, and you think you want to be one of the first to undergo treatment here at your beloved medical home. Now it’s time to finally consider the following questions…

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  1. Do depression symptoms interfere with your day-to-day life?
  2. Are you dissatisfied with results from your antidepressants?
  3. Have you worried about side effects from your depression medication?
  4. Are you interested in a proven, non-drug therapy for your depression?
  5. Have you tried more than two(possibly more than 4) different antidepressant treatments?

If you answered yes to several of these questions, you should contact your Primary Care Provider to learn more about TMS Therapy. Dr. Nora, Dr.
Kate, and everyone else at AFP will be working closely with Neurostar TMS Therapy to bring this exciting machine to Research Drive. The machine itself is expected to arrive next week, and we’re hoping to have technicians trained in the following few weeks.. We couldn’t be more excited to get the ball rolling with this innovative technology!

 

(NOTE: TMS is not right for you if you have a non-removable conductive metal in/near the head. There is a rare risk of seizure associated with the use of TMS in patients who have a high potential for seizure based on genetic history. TMS has not been studied in patients who have had no prior antidepressant treatments)

This post was written by Victoria Palmatier.