South Florida Sun-Sentinel.com
High-tech machine helps with depression
By Nicole Brochu, Staff Writer
10:29 AM EDT, September 21, 2012
But here's the real downer: They only work for about 30 percent of those who take them, studies suggest.
Now, a new, non-invasive procedure performed in a doctor's office without anesthesia or major reported side effects is helping a growing number of South Floridians find the peace and functionality no other treatment could deliver.
Cleared in 2008 by the Food and Drug Administration to treat depressed adults who failed to get results from at least one antidepressant, Transcranial Magnetic Stimulation uses highly focused magnetic impulses to stimulate key neurons in the brain during daily, 40-minute treatments in a high-tech chair over six weeks or so.
The technology has proven so groundbreaking — in treating depression and other brain disorders — that Palm Beach psychiatrist Dr. Aron Tendler likens it to the advent of stents in treating arterial diseases.
"This new technology is changing the way we treat diseases of the brain," Tendler said. "It's the start, not the finish."
Palm Beach landscape business owner Brett Armstrong says the therapy has "changed my life."
After developing bipolar disorder from head trauma suffered in a 2003 motorcycle wreck, Armstrong said he tried multiple medications before sticking with one, Seroquel, that helped ease the manic symptoms of his disorder. But he was taking such a high dose, 600 to 800 milligrams a day, that the "blanket" of lethargy it threw over his day had an indelible impact on his business.
That's when the folks at Tendler's office suggested TMS. "Since TMS, I feel better. It's almost like I beat it," Armstrong said. "I've got a normal life now."
Dr. Darryl Appleton, a Delray Beach psychiatrist, said society doesn't realize how prevalent depression is in America today, or how many people struggle on medication, either because of side effects or because they produce few results.
"Our average patient has had 18 previous medication trials, and a lot of them have been hospitalized, too. So when they come in here, they're looking for a piece of hope," Appleton said.
He called TMS revolutionary in offering his patients an effective option to antidepressants or more extreme treatments like electric shock therapy, which remains controversial. Many TMS patients see a difference after just a few sessions.
Using a small magnetic coil applied to the head, at the left prefrontal cortex, TMS sends 80 pulses of electrical currents a minute to target the area of the brain that controls mood. The currents stimulate cells that are thought to release neurotransmitters like serotonin, norepinephrine and dopamine — mood-regulating chemicals that are out of balance for many suffering depression.
A 2010 study published in the journal Brain Stimulation showed TMS produced lasting relief in patients with major depression, and only 13 percent of those studied relapsed after six months.
Other research suggests TMS can be effective in treating brain conditions like Parkinson's disease, post-traumatic stress disorder, fibromyalgia, strokes, even drug cravings for addicts.
But because it's still considered relatively new, it doesn't come cheap. The cutting-edge machinery and computerized chair cost about $75,000, according to Neuronetics, the machine's creators.
And because it's not yet covered by insurance or Medicare in Florida, patients fork out $400 per session. Since a full course of treatment takes 20 to 30 daily sessions, that could prove pricey.
But the cost is worth it for West Palm Beach retiree Rebecca Summers, who has suffered from chronic depression for years and has long since found antidepressants ineffective. Before TMS, she said, "I had absolutely no interest in doing anything."
She noticed an immediate difference after just a few sessions. After 10 treatments, her depression score went from 39 to 22, and after 20 sessions, it fell to 14. A score of under eight is considered normal, Appleton said.
"It's unbelievable," Summers said. "It's important for people to know what this can do for them."
Though the literature lists a rare risk of seizures for some people, Appleton said his patients typically complain of mild, temporary side effects like a tapping feeling at the scalp during treatment and tiredness after.
Unless the insurance industry embraces the therapy more fully, though, it will remain an option only for patients who have already tried psychotherapy and medications first.
"There's no shortage of need," Tendler said. "Once insurers are more willing [to cover it], we'll be seeing that we'll be able to help a tremendous amount of people."