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Treatments

REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (rTMS)

Repetitive transcranial magnetic stimulation (rTMS) is a new technology that is showing promise as a treatment for depression.

rTMS involves holding an insulated coil in contact with the scalp and passing a strong current around the coil. This creates a magnetic field that passes through to the brain. When the current is rapidly fluctuated, the magnetic field fluctuates causing tiny secondary currents in the brain.

ECT is regarded as the most powerful antidepressant available (Abrams, 1997), and a study conducted by Professor S Pridmore at the Royal Hobart Hospital in Tasmania suggests that under certain circumstances, rTMS can achieve results similar to ECT, without the impact on memory that ECT has. There is a link to the research article in the International Jornal of Neuropsychopharmacology below.

The following is taken from the article "A bright spot on the horizon: Transcranial magnetic stimulation in psychiatry" written by Matthew Kirkcaldie and Saxby Pridmore for for Open Mind, the journal of the Tasmanian Association for Mental Health.

"The magnetic fields used in TMS are produced by passing current through a hand-held coil, whose shape determines the properties and size of the field. The coil is driven by a machine which switches the large current necessary in a very precise and controlled way, at rates up to 50 cycles per second in rTMS. The coil is held on the scalp - no actual contact is necessary - and the magnetic field passes through the skull and into the brain. Small induced currents can then make brain areas below the coil more or less active, depending on the settings used.

Research
Dealing with depression
REPORTER: Dr John D'Arcy
BROADCAST DATE: May 25, 2004, Today Tonight

  • There are many different studies concerning rTMS located at this site.

    COMMENTS
    by people who have had Transcranial Magnetic Stimulation treatment.


    My name is Michael and I contributed the post in regards to the TMS treatment one month after I completed the treatment. It's now been 5 months and this is an update that you can put on the website if you wish.

    It has now been approximately 5 months since the completion of TMS treatment at the Prince Of Wales Hospital in Randwick. During these months I have not had any therapy or taken any medication.

    My last post one month after the treatment did seem positive, but now I can quite confidently (and unfortunately) say that the treatment has had no long term benefit for me. I am back to how I was at the beginning of the treatment which is living in a chronic depressed state.

    It's possible my enhanced mood after the initial treatment was due to the change in lifestyle and the hope associated with going to hospital everyday with the possibility of getting better. It did shake things up a little and I guess stimulated my life for that treatment time, but all the positive effects of this brief life change have faded.

    So in the end,  I can only assume that for myself the treatment was ineffective as a treatment just on it's own.

    (18/01/2005)

    It has been one month after finishing a 6 week course of Trans Cranial Magnetic Therapy at the Prince of Wales Hospital Sydney. The treatment involved me going to the hospital every day for the 6 weeks, lying down on a typical doctor’s bed and having a magnetic coil placed over the front left part of my head (specifically the left frontal lobe of my brain). The first two weeks I was given the "sham" treatment that they have to use in the study to see if T.M.S is actually effective. The sham treatment followed the same procedures as the real treatment, but the magnetic pulse was not emitted from the machine, and I wasn't told if I was getting the real stuff or not.

    After 2 weeks of that, twice a day, I was informed it was the sham treatment. I sort of had an inkling because I was feeling worse even though I hoped I was getting the real treatment. So after that began the real treatment, 2 weeks of two 20 minute sessions a day, then 2 weeks of one 40 minute session a day. At first, the treatment was unusual. There was irritation, it literally felt like someone was tapping hard on my skull, but not long after I got used to it, but I won't deny, it was a bit of a shock at first ( my level of magnetic stimulation was high, they do a test in the beginning to judge your 'threshold').

    During the treatment you see a psychologist once a week for check ups on how it is going. It is not a combined treatment (psychological therapy and T.M.S), rather just the psychologist asking questions to see if you are improving.

    It is very hard to know if you are getting better, and I just tried not to think about it until it was all over.

    And now it is all done, how do I feel? I don't take any anti-depressants and at the moment am not undergoing therapy of any sort and after one month and can say, perhaps with a bit of my usual cynical caution, that my mental state has improved.

    How so? I don't seem to be dwelling as much on negative things and find it easier to be positive. The depression and its impact on my life has lessened, and for me to be able to say that, is a very scary, drastic, unusual thought (i.e. I could start to think; what if I’m wrong and I sink back into it depression! ). My life seems lighter and I feel there may at last be some hope, as I want to improve and am not as scared as I was about failing to get better and fearing that I can't improve.

    This is after one month, and whether or not this is a placebo effect I don't know, I will just have to wait and see what happens. I dare not say I have 'recovered' but I would say I am improving, and really any improvement for me is amazing after having been depressed for so long.

    So there is hope, and the knowledge that depression truly is the result of a dysfunctional brain, specifically the brain not working as it should be in the left frontal lobe, the area that deals with happy emotions etc,  helps me to understand that the fight against it isn’t futile, and it's not my fault.

    (14/09/2004)


    The factual information on rTMS was compiled from:
    University of Tasmania (http://www.utas.edu.au/)


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