New Form of Magnetic Stimulation for Severe Depression (Premium)
Severe depression is one of the most difficult conditions to successfully treat. Researchers at Stanford University School of Medicine have found that a revised form of magnetic brain stimulation relieved symptoms in 90% of subjects in a small study on severe depression. A non-noninvasive approach, it was used for people who had not responded well to medication, talk therapy, or other forms of electromagnetic stimulation.
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Transcranial magnetic stimulation (TMS) uses magnetic fields to stimulate nerve cells in the brain. The revised treatment is called Stanford Accelerated Intelligent Neuromodulation Therapy, or SAINT. It is a form of transcranial magnetic stimulation, which is approved by the Food and Drug Administration for treatment of depression.
The researchers reported that the therapy improves on current FDA-approved protocols by increasing the number of magnetic pulses, speeding up the pace of the treatment and targeting the pulses according to each individual’s neurocircuitry.
In traditional transcranial magnetic stimulation, electric currents from a magnetic coil placed on the scalp excite a region of the brain implicated in depression. The treatment, as approved by the FDA, requires six weeks of once-daily sessions. Only about half of patients who undergo this treatment improve, and only about a third experience remission from depression.
Stanford researchers hypothesized that some modifications to transcranial magnetic stimulation could improve its effectiveness. Studies had suggested that a stronger dose, of 1,800 pulses per session instead of 600, would be more effective. The researchers were cautiously optimistic of the safety of the treatment, as that dose of stimulation had been used without harm in other forms of brain stimulation for neurological disorders, such as Parkinson’s disease.
“The less treatment-resistant participants are, the longer the treatment lasts,” said postdoctoral scholar Eleanor
All study participants were severely depressed, and all had suicidal thoughts before the therapy. None of them reported having suicidal thoughts after treatment. All 21 participants had previously not experienced improvements with medications, FDA-approved transcranial magnetic stimulation or electroconvulsive therapy. Afterward, 19 of them scored within the nondepressed range on a standard test for depression.
Minimal side effects
The only side effects of the new therapy were fatigue and some discomfort during treatment, the study reported. The results will be published online April 6, 2020 in the American Journal of Psychiatry.
“There’s never been a therapy for treatment-resistant depression that’s broken 55% remission rates in open-label testing,” said Nolan Williams, MD, assistant professor of psychiatry and behavioral sciences and a senior author of the study. “Electroconvulsive therapy is thought to be the gold standard, but it has only an average 48% remission rate in treatment-resistant depression. No one expected these kinds of results.” (Editor: Electroconvulsive therapy has significant risk of serious side-effects.)
Cole, PhD, a lead author of the study.
The researchers plan to study the effectiveness of SAINT on other conditions, such as obsessive-compulsive disorder, addiction and autism spectrum disorders.
At one month after treatment, 60% of subjects retained the improvement.
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