If you or someone you know is suffering from major depressive disorder (AKA) mdd, you are not alone. ”16 million to 18 million Americans suffer every year” according to Mahmoud S.Okasha M.D., who has seen his share of depressed patients in his 44 years of psychiatric experience.
Transcranial Magnetic Stimulation- major depressive disorder mdd treatment
Dr. Okasha, Norwich Bulletin: “She was then referred to me and her antidepressant was switched, and she began psychotherapy. Her mood improved to some degree but she still complained of lack of motivation, poor energy, inability to enjoy hobbies (crossword puzzles, cooking, and her three grandchildren).
After a year of treatment with minimal improvement, I suggested Transcranial Magnetic Stimulation. The patient agreed and within three weeks she was back doing crossword puzzles and cooking. Within four weeks she was spending more time with her grandchildren — she looked forward to going to work, her concentration was much better, she reconnected with her friends, enjoyed going out to dinner with family, gained back weight she had lost and felt her life was meaningful again.
TMS is the latest non-pharmaceutical treatment modality for major depressive disorder that does not respond to other treatments. In a large clinical trial done by the National Institute of Mental Health involving more than 4,000 patients, it was found that only 30 percent of patients treated with antidepressants were totally free of any symptoms of depression.
TMS works by stimulating key neurons in the brain believed to be involved in the pathophysiology of depression. Unlike antidepressants that are swallowed and circulate in the body, TMS delivers high intensity focused magnetic pulses that lead to the formation of electrical currents, which are transmitted to deeper structures that are also associated with symptoms of depression.
The electric impulses stimulate neurons to increase neurotransmitters that are lacking in depressed individuals. Unlike medication, TMS does not lead to side effects, and unlike electro convulsive therapy, it does not require anesthesia or muscle relaxants and does not lead to any memory problems. It is a safe and effective treatment.
Typically a patient will drive to the office, receive the treatment while lying awake in a comfortable reclining chair for the 40-minute session, and can drive back to work or home. The course of treatment is approximately 20 sessions to 30 sessions and is given five days a week. Some patients may require a booster session after six months and some may need to continue on antidepressants, but will definitely require less pharmacological intervention. Read more
Transcranial Magnetic Stimulation: Doctors and Scientist don’t understand why it works but agree treatments do something:
Dr Shock, MD, PHD point of view: Dr Shock is skeptical about the possibilities of Transcranial Magnetic Stimulation (TMS) influencing the neural networks involved with depression. TMS can influence the cortex on the surface and probably a few centimeters beyond. In research TMS has been used to disrupt neural activity experimentally in studies of human cognition but relatively little is known about how TMS works.
Effects of TMS on brain functions:
1.Single burst TMS instead of repetitive TMS applied to the visual cortex interferes with visual imaging (repeated stimulation=rTMS has a longer lasting effect than a sinle burst)
2. Stimulation of the right spot in the motor cortex causes the thumb to twitch (intensity calibration of the TMS stimulus, this is used before repetitive stimulation to other parts of the scalp (rTMS))
3. Low frequency stimulation (1-5 pulses per second) depress brain activity, higher frequency stimulation (25 or more pulses per second) increases excitability.
4. Stimulation of the left prefrontal cortex with rTMS relieves depression in some patients who haven’t responded to other antidepressant treatments
5. Low frequency rTMS to the temporoparietal cortex (above the ear) reduces auditory hallucinations in Schizophrenia
6. rTMS treatment on speech areas of the brain can make people name picture at a faster rate
7. rTMS applied to motor regions of the brain facilitates lightening fast movements
8. rTMS applied to the prefrontal cortex compared to sham rTMS enhances solving of analogy puzzles, rTMS might facilitate thinking. (Try rTMS before an exam). rTMS may raise baseline level of neural activity just enough so that neurons don’t have to work hard to retrieve memory or problem solving strategies. read more
Joel Lamoure, RPh, BSP, FASCP , Assistant Professor, Department of Psychiatry says: “Transcranial magnetic stimulation (TMS) seems to be a much needed treatment for patients with major depressive disorder who are treatment resistant. continue
Whether Transcranial Magnetic Stimulation for major depressive disorder mdd will work specifically for you, one thing is for certain- the treatment has helped a lot of patients and in our opinion, definitely worth looking into especially if the medication you are taking is not working.
Dr. Mahmoud Sarwat Okasha can be reached at:
200 W Town St
Norwich, CT 06360
Practice: (860) 886-1508