About half of all patients fail to respond to antidepressants for depression. Most patients who have been treated with multiple antidepressants are still severely depressed – they do not achieve wellness. A small variety of interventions have been perfected for so-called “treatment-resistant depression”. Following many years of testing the FDA approved (in 2008) rTMS as a technique for assisting previously treatment-resistant depression patients. It is an office-based procedure and does not involved anesthesia.
During the procedure, the patient can relax in a comfortable chair while reading or other pastimes such as music-listening or computer work. A small, curved device called the “head-coil”, which is about the size of a cupped hand, rests lightly on the patient’s head, delivering focused magnetic stimulation directly to the area of the brain thought to be involved with regulating mood. The magnetic field pulses are similar to those used in magnetic resonance imaging (MRI) machines. The usual course of treatment is daily for 6 – 7 weeks, and some receive regular intermittent treatments (called Maintenance rTMS or Continuation rTMS) to avoid further episodes.
rTMS has approval from the U.S. Food and Drug Administration (FDA) to treat four conditions:
- Major Depression (including treatment-resistant depression)
- Obsessive Compulsive Disorder (OCD)
- Migraine Headaches
- Cessation from Smoking
rTMS is commonly applied in these other conditions as an advanced indication (they not currently FDA-approved):
- Addiction
- Alzheimer’s disease
- Bipolar Disorder (especially Bipolar Depression)
- Borderline Personality Disorder (BPD)
- Chronic Neuropathic Pain
- Disordered Eating
- Essential Tremor
- Fibromyalgia
- Memory & Cognitive concerns
- Parkinson’s disease
- Post-Traumatic Stress Disorder (PTSD)
- Schizophrenia
- Stroke Rehabilitation
- Tinnitus and Auditory Hallucinations
- Traumatic Brain Injury
