For a long time, it has been widely known that clinical depression is a complex mental illness. Depression interferes with the ability to live and engage in life. It can be challenging to struggle with a depressed mood that does not respond to treatments. And some depression is not effectively treated despite several medications and psychotherapy attempts.
Through continued research and advances in treatment options, Transcranial Magnetic Stimulation (TMS) therapy passed FDA clearance in 2008, and it was that year that I began to offer this treatment alternative to patients. TMS is a treatment approach that passed the rigors of a randomized, placebo-controlled and multi-center study for depression treatment for individuals that did not respond to a previous course of treatment.
When my practice started our TMS therapy initiative, our overarching goal was simple—that some patients would respond. Eight years later, we have compiled six lessons learned from our TMS journey.
We have learned that TMS works for most people. Further clinical studies show that more than 50 percent of patients respond and our experience shows that 75 percent of patients respond. We have treated roughly 400 patients ranging from late teens to people in their 90s, who are from all walks of life. In large part, these individuals have tried multiple attempts at treating their depression.
We have learned that people tolerate TMS well. In early studies with the TMS technology system we use, there was a less than five percent dropout rate, and in clinical practice it is rare. Given TMS therapy’s non-invasive, in-office treatment application, patients can drive to treatment then go to work, school, the store or even the gym afterward. While managing a TMS treatment plan, we encourage all patients to take care of themselves physically, nutritionally and socially, so that the treatment has the best chance of working.
We have learned that it is difficult to help people understand TMS, even to know that it is an available treatment option. Personally, I have given dozens of industry presentations, have been featured on radio and TV and have been in numerous publications discussing what TMS is and its benefits, yet it seems there is a disconnect among the general population that they do not know about TMS or fully understand TMS. Given my profession, I live in the TMS space every day, so I have a specific perspective that others do not. No matter what I think people should know, they only know what they know. This disconnect also includes clinical colleagues that view TMS as a departure from traditional treatments. TMS therapy certainly is, as it appears to be more effective, in many instances, and more sustainable as it directly targets the circuits within the brain involved in depression.
We have learned that while awareness for TMS is lacking, the technological advances maintain progression, as there are now five FDA-cleared systems that treat depression utilizing TMS, beyond the initial platform that started the clinical use of TMS. Plus, the international organization, The Clinical TMS Society, brings together thought leaders to learn and grow this technology, which continues to make great strides.
We have learned that TMS is a treatment in evolution. We have a protocol, and we have experience that people are unique and individual. New research is showing that variations of the established protocol may provide benefit. That makes TMS therapy an exciting area of clinical work, and it makes me hopeful that there may be a time when we can improve our current response rate.
We have learned that although depression is a complex mental illness, we can empathize with the struggle, we can encourage people through the treatment, and when someone tells us they feel joy for the first time in years, we can celebrate with them.
These six lessons learned have helped my practice refine our efforts in educating and growing awareness for TMS as a proven treatment option for depression. Our goal remains the same, as we are committed to helping people live fuller, happier lives.