Mmillions of them take medication To treat his depression. But for many, the drugs don’t work: They either have minimal or no effect, or the side effects are intolerable. what are these patients called treatment-resistant depression,
One promising treatment for such patients is a type of brain stimulation therapy. called transcranial magnetic stimulation,
This treatment is not new; It’s been around since 1995. US Food and Drug Administration Transcranial magnetic stimulation approved in 2008 For adults with “non-psychiatric treatment-resistant depression,” which is usually defined as failure to respond to two or more antidepressant medications. More recently, in 2018, the FDA approved for some patients with obsessive-compulsive disorder And smoking cessation,
Insurance These treatments usually include, Both the psychiatrist and the equipment operator must be certified. While the treatment has been available for years, the equipment to perform the procedure is so expensive that few private psychiatric practitioners can afford it. But with increasing recognition of the potential of transcranial magnetic stimulation, the price will eventually come down and access will greatly increase.
Does it work?
Transcranial magnetic stimulation is a non-invasive, pain-free procedure with minimal to no side effects, and it often works. Research shows that 58% of once treatment-resistant patients experience a significant reduction in depression After four to six rounds of therapy. More than 40 independent clinical trials – with over 2,000 patients worldwide – have demonstrated that repetitive transcranial magnetic stimulation is an effective therapy To the treatment of resistant major depression.
as a professor and psychiatrist For those who have used transcranial magnetic stimulation to treat some of my patients, I have seen a reduction in depression symptoms even within the first two weeks of treatment. What’s more, the effects persist after treatment ends, usually for six months to a year. After that, the patient has the option of maintenance treatment.
about the process
For the patient, the process is easy and simple. Sits in a comfortable chair with a comfortable pillow that holds their head in place, puts on earplugs and can then relax, check their phone, watch TV or read a book.
A treatment coil, shaped like the figure 8, is placed on the patient’s head. A nearby exciter sends current to the coil, which converts the current into a magnetic field,
area, which is highly focused, turns on and off rapidly when targeting a part of the prefrontal cortex The area of the brain responsible for regulating mood.
Researchers know that people with depression have decreased blood flow and decreased activity in that part of the brain. transcranial magnetic stimulation causes an increase in the level of both blood flow and dopamine And glutamate Two neurotransmitters that are responsible for brain functions such as concentration, memory, and sleep. It is the repeated stimulation of this area – the “depression circuit” of the brain – that brings about the antidepressant effect.
This is not ‘electroshock’ or deep brain stimulation
Some people confuse transcranial magnetic stimulation with electrotherapy, a procedure used for patients with severe depression or catatonia. With electroshock therapy, the anesthetized patient receives a direct electric current, which causes seizures. Typically, people who go through this process experience some memory loss after treatment,
Transcranial magnetic stimulation is very different. It does not require anesthesia, and does not affect memory. The patient can resume daily activities right after each treatment. Dormant brain connections are restarted without causing a seizure.
also not to be confused with deep brain stimulationwhich is a surgical procedure that is used to treat obsessive-compulsive disorderTremors, epilepsy and Parkinson’s disease.
side effects and accessibility
patients with transcranial magnetic stimulation undergo total 36 treatments, 19 minutes each, for three to six weeks. Research has concluded that this is the best protocol for treatment. Some patients report that it feels like someone is patting them on the head. Others don’t feel anything.
Some very minor side effects may occur. The most common during treatment is flushing of the face and discomfort in the scalp, sensations that go away after the session is over. Some patients complain of mild headache or discomfort at the application site. Depending on how effective the therapy was, some patients return for follow-up every few weeks or months. It can be used in addition to medicines or without any medicines.
Not everyone can go through depression brain stimulation therapy, Those with a history of epilepsy or head injury may not be eligible. People who have metal fillings in their teeth are fine for treatment, but people who have non-removable metal devices implanted in or around their head are not fine. Pacemakers, defibrillators, and vagus nerve stimulators may also not be eligible, as the magnetic force of the treatment coil may deflect these devices and cause severe pain or injury.
But for those who are able to access the therapy, the results can be remarkable. For me, it’s amazing to see these patients smiling again – and coming out on the other side feeling hopeful.
Patricia JunqueraAssociate Professor and Vice President of Clinical Services, Florida International University
This article is republished from Conversation Under Creative Commons Licence. read the original article,
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