Posted by Psychquackery on August 25, 2003, at 8:41:03
In reply to Re: efficacy of rTMS for depression, posted by Pfinstegg on August 25, 2003, at 2:24:45
> I had a three-week course of TMS in January which, in my opinion, resulted in a complete remission from a severe depression which had been present for about 10 years, and had not responded to medications. The remission lasted four months, and then a mild degree of depression returned. This responded well to Lexapro. However, the experience of the doctor who administered the TMS is that, on average, if it is effective, the results last for about four months; because of that, he recommended short "booster" treatments every few months. Because it is such a physiologically "good" treatment, increasing blood flow to the prefrontal areas, lowering cortisol output, and nudging the neurotransmitters towards more normal levels, I have decided to go back for regular two-per-day booster sessions, which they usually give in a group of six treatments, rather than rely on an SSRI, even a fairly good one.
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> As to the depth the magnetic currents reaches, it was my doctor's opinion that while the current itself only goes in about 2-3 centimeters, there are concurrent changes in the brain which reach deeper. As to its effectiveness, the success rate was about 64%Is that 64% rate effectiveness for psychotic depression and mania? The most severe and chronic forms of depression? I seriously doubt it. I have not seen any studies which assessed whether rTMS was as effective as ECT for psychotic depression and mania or catatonia. For those, the big guns must be used, such as ECT.
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> As to building your own TMS machine, I can only say- wow-more power to you! That's so impressive!
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> Pfinstegg
I was in the rTMS trials myself as well and my experience didnt turn out so good like yours did. I have severe depression, with high blood plasma cortisol levels, have been diagnosed with psychotic depression once, etc. I personally do not believe rTMS in any form has the strength to cut the mustard so to speak for severe depression.Mark George personally did most of my rTMS treatments. And I find it ironic that in this article he says ECT is the only treatment currently available with clinical relevance for severe depression. I also disagree with your doctor about the effects of rTMS reaching deeper than the outer cortex of the brain (is he an rTMS researcher or just some Pdoc who read some rTMS articles?). ECT by contrast, goes right down to the core of your brain...in fact every single neuron in your brain is fully activated and "fired" during an ECT seizure.
In the article in Scientific American, it discusses how rTMS researchers are in puruit of the "holy grail." That is, they are pursuing a machine that will allow them to magnetically stimulate the deeper regions of the brain safely. This is what ECT currently does. If this can somehow be attained, it will result in true theraputic clinical relevance. rTMS presently has little real world clinical relevance.
As for me, I will stick to ECT for now. Cause it actually works.
Igor
poster:Psychquackery
thread:253579
URL: http://www.dr-bob.org/babble/20030823/msgs/253822.html