Source: DGNews  |  Posted 1 year ago

CHICAGO -- October 12, 2010 -- In a study to determine the durability and
long-term effects of transcranial magnetic stimulation (TMS), psychiatric
researchers have found that the noninvasive, non-drug therapy is an effective,
long-term treatment for major depression. Results of the study were published
in the October 2010 issue of Brain Stimulation, a journal published
by Elsevier.

TMS therapy delivers highly focused magnetic field pulses to a specific portion
of the brain, the left prefrontal cortex, in order to stimulate the areas of
the brain linked to depression. These pulses are of a similar intensity to the
magnetic field produced during an MRI imaging scan. The repeated short bursts
of magnetic energy introduced through the scalp excite neurons locally and in
connected areas in the brain.

TMS received clearance from the US Food and Drug Administration (FDA) in
October 2008. This novel treatment option is a safe and effective, acute
antidepressant therapy, but there is limited information on its long-term
benefits.

“This is the only prospective, maintenance, follow-up study which assesses the
durability of acute TMS benefit in patients with major depression,” said
principal investigator Philip G. Janicak, MD, Rush University Medical Center,
Chicago, Illinois.

In the study, 301 patients with major depression were randomly assigned to
receive active or sham TMS in an acute, 6-week, controlled trial. Patients who
responded then underwent a 3-week, transition period where they were tapered
off of active or sham TMS treatment and started on a standard antidepressant
for maintenance. After any successful acute treatment for depression such as
TMS, antidepressant medications, or electroconvulsive (ECT) therapy, it is
usual practice to introduce maintenance medication to lessen the chance of
relapsing.

In the acute, randomised trial, 142 patients who received active TMS therapy
responded and entered the 3-week, transition phase. Of these, 121 completed
this phase without relapse. A further 99 (81.8%) then agreed to be followed for
an additional 24-week period, during which only 10 patients relapsed.

In addition, TMS was successfully used as an intermittent rescue strategy to
preclude impending relapse in 32 of 38 (84%) patients. This indicated that the
therapeutic effects of TMS are durable in the majority of acute responders and
that reintroduction of TMS as an adjunct to medication was effective and safe
in preventing relapse.

“The results of the follow-up study further support TMS as a viable treatment
option for patients with major depression who have not responded to
conventional antidepressant medications,” said Dr. Janicak. “After acute
response to TMS, a standardised regimen of antidepressant medication maintained
the acute benefit in the majority of patients over a 6-month period.”

The FDA-approved TMS device was developed by Neuronetics, Inc. Patients treated
with TMS therapy do not require anaesthesia or sedation and remain awake and
alert. It is a 40-minute outpatient procedure that is prescribed by a
psychiatrist and performed in an outpatient setting. The treatment is typically
administered daily for 4 to 6 weeks.

Researchers estimate that by the year 2020, depression will be the second
leading cause of disability worldwide. About two-thirds of those who experience
an episode of depression will have at least one other episode in their lives.
Existing treatment options for depression are frequently ineffective or
intolerable due to side effects. Current antidepressant therapies are not
beneficial for at least one-third of depressed individuals, leaving many with a
lack of adequate treatment options.

SOURCE: Rush University Medical Center