Repetitive transcranial magnetic stimulation offers relief from depression: Expert

THE TIMES OF INDIA

 

Repetitive transcranial magnetic stimulation offers relief from depression: Expert

Umesh Isalkar, TNN | Jul 28, 2013, 07.02 PM IST

PUNE: Rakesh used to feel low. Soon he lost interest in his job. He took to alcohol to feel better and things kept going downhill after his wife walked out. When he approached doctor for treatment of depression, he had already spent two years in depression.

Today, Rakesh has almost recovered and leading a normal and productive life. Thanks to a new treatment modality called repetitive transcranial magnetic stimulation (rTMS). Rakesh is just one of many suffering from depression and one of the few who got it treated.

According to WHO ( World Health Organization) report depression is going to be second leading cause for disability and India is going to have maximum number cases in world by 2020. Problem however is not the illness but lack of awareness and stigma attached to it.

"Depression if not treated can last for more than a year. Treatment is necessary as depression can lead to professional, family, financial, and physical health related complications including suicide," said psychiatrist Swapnil Deshmukh of Shreeyash Hospital who has treated Rakesh with rTMS.

Various types of treatment modalities are available depending on severity of illness including cognitive behavioural therapy (CBT), medicine, electro convulsive therapy (ECT), and latest - rTMS ( re-petitive Transcranial magnetic stimulation). All these are standard, well proved and accepted worldwide -FDA approved treatment modalities.

"Around 20% of cases are mild and can be treated with CBT itself but remaining requires medications in addition to counselling. Around 30 to 40% of depression cases can be severe, resistant to treatment, and may require long term medications in these shock treatment (ECT) is very effective," Deshmukh said.

"rTMS is a resent treatment modality in depression and other psychiatric illness in which magnetic waves can directly stimulate affected- less functioning brain areas non-invasively. It is considered to be safest, non-medicine dependent, cost effective treatment modality getting very popular in west. Combination of above mentioned treatment work better," Deshmukh said

Usually, patients with milder depression respond within 3 to 6 weeks, but severe resistant depression may take longer duration, he added.

http://timesofindia.indiatimes.com/city/pune/Repetitive-transcranial-magnetic-stimulation-offers-relief-from-depression-Expert/articleshow/21428708.cms

Brain Scans Predict Best Course of Treatment for Patients with Depression

June 13, 2013

Helen S. Mayberg, M.D.
 

Brain & Behavior Research Foundation Scientific Council Member and three-time NARSAD Grantee Helen S. Mayberg, M.D., was principal investigator for a study that showed that specific patterns of brain activity can help indicate how a depressed person will respond to treatment with medication or psychotherapy. The study results, published in JAMA Psychiatry online on June 12, 2013, offer a first step towards personalized medicine treatment decisions for major depression. The findings are especially important because at present less than half of patients experience remission with the treatment initially selected.
 

Dr. Mayberg has long been committed to improving the lives of patients with depression and other mental illnesses. She pioneered the use of positron emission tomography (PET) to investigate brain changes in depressed patients with her first NARSAD Young Investigator Grant 20 years ago. Since that time, with the support of two further NARSAD Grants―and countless other grants―she successfully identified a key locus of pathology in depression (the subcallosal cingulate or Brodmann Area 25) and piloted the use of deep brain stimulation (DBS) to target this “Area 25” to treat patients with resistant depression.
 

Her new study sought to identify a biomarker that could predict which type of treatment a patient would benefit from based on the individual’s brain activity. The research team measured brain glucose metabolism (a critical brain function) in two groups of participants during a span of 12 weeks. After having a PET scan, half of the participants were given an antidepressant medication and the other half were given cognitive behavior therapy (CBT).The researchers found that less activity in the brain’s anterior insula indicated response to CBT, and more activity indicated response to medication.
 

"To be ill with depression any longer than necessary can be perilous," says Dr. Mayberg, Dorothy C. Fuqua Chair in Psychiatric Imaging and Therapeutics, Emory University School of Medicine. "This is a serious illness and the prolonged suffering resulting from an ineffective treatment can have serious medical, personal and social consequences. Our goal is not just to get patients well, but to get them well as fast as possible, using the treatment that is best for each individual."
 

"These data suggest that if you treat based on a patient's brain type, you increase the chance of getting them into remission," says Dr. Mayberg. More study is needed to confirm how this approach may be used to deliver treatments more effectively and how to apply it to different types of depression.
 

http://bbrfoundation.org/brain-matters-discoveries/brain-scans-predict-best-course-of-treatment-for-patients-with-depression