Psychiatric researchers at Rush University Medical Center have found a non-invasive, non-drug therapy to be an effective, long-term treatment for major depression.
The study was done to determine the durability and long-term effects of transcranial magnetic stimulation (TMS).
TMS therapy is a non-invasive technique that delivers highly focused magnetic field pulses to a specific portion of the brain, the left prefrontal cortex, in order to stimulate the areas of the brain linked to depression.
These pulses are of a similar intensity to the magnetic field produced during an MRI imaging scan. The repeated short bursts of magnetic energy introduced through the scalp excite neurons locally and in connected areas in the brain.
TMS received clearance from the U.S. Food and Drug Administration (FDA) in October 2008. This novel treatment option is a safe and effective, acute antidepressant therapy, but there is limited information on its long-term benefits.
In the study, 301 patients suffering from major depression were randomly assigned to receive active or sham TMS in an acute, six-week, controlled trial. Patients who responded then underwent a three-week, transition period where they were tapered off of active or sham TMS treatment and started on a standard antidepressant for maintenance. After any successful acute treatment for depression such as TMS, antidepressant medications or electroconvulsive (ECT) therapy, it is usual practice to introduce maintenance medication to lessen the chance of relapsing.
In the acute, randomized trial, 142 patients who received active TMS therapy responded and entered the three-week, transition phase. One hundred twenty-one patients completed this phase without relapse. Of those patients, 99 (81.8 percent) then agreed to be followed for an additional 24-week period during which only 10 patients relapsed.
In addition, TMS was successfully used as an intermittent rescue strategy to preclude impending relapse in 32 of 38 (84 percent) patients. This indicated that the therapeutic effects of TMS are durable in the majority of acute responders and that reintroduction of TMS as an adjunct to medication was effective and safe in preventing relapse.
Results of the study were published in the October 2010 issue of Brain Stimulation, a journal published by Elsevier.