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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by deli on July 27, 2002, at 14:04:17
Hello Everyone,
I am back after a short relapse with my tears saturated pillows and blanket. I had my monthly visit with my enchanting pdoc (Oh, how I love to visit!) Anyways, we decided to continue on with the same concoction of Remeron, Prozac and Topamax. During our unusual conversation and I say unusual because the last few months all I do in his office is sob, I asked him about TMS.
He said that the research on it seemed promising. He then later added that our University was presently conducting research through the Department of Psychiatry and the Brain Institute.
I asked him if I should volunteer for the research and he was open to the idea. Anyway, I called and had a preliminary interview over the phone and got an appointment to meet with the psychiatrist conducting the study, for a two hour evaluation. After that, if they determined that I qualify for the study ( I guess am depressed enough) they will perform a battery of tests including pet scan, cat scan, mri, ekg, full physical and cognitive testing to rule out any physical condition. ( how cool is that; that's what I've tried doctors to do all my life)So I am going to be one of their guinea pigs.
Apparently, TMS is a safer version of ect in that it causes no memory loss and no anesthesia is needed. I don't know anyone that has had it done. So I am sharing this with you in the event someone knows of this treatment and can shed some light on it.
P.s. Yes, Topamax would be discontinued if I participate in the study.Love
Deli;)
Posted by velaguff on July 27, 2002, at 16:04:06
In reply to Transcranial Magnetic Stimulation anyone?, posted by deli on July 27, 2002, at 14:04:17
Best of luck with this promising new treatment! The research I've read about makes it look good. Let us know how it works, and if possible, humor me on one question: to what extent you can, when they explain to you how the equipment works, ask yourself, is this a complex, risky procedure, and/or does it require complicated, expensive equipment (or could the equipment possibly be cheapened through pending technological advances)? Or if one had the freedom and the right equipment, could one administer one's OWN treatment?
Posted by deli on July 27, 2002, at 16:47:27
In reply to Re: Transcranial Magnetic Stimulation anyone?, posted by velaguff on July 27, 2002, at 16:04:06
> Best of luck with this promising new treatment! The research I've read about makes it look good. Let us know how it works, and if possible, humor me on one question: to what extent you can, when they explain to you how the equipment works, ask yourself, is this a complex, risky procedure, and/or does it require complicated, expensive equipment (or could the equipment possibly be cheapened through pending technological advances)? Or if one had the freedom and the right equipment, could one administer one's OWN treatment?
OOh! I'm counting they are going to have the latest Super Dooper, R2D2, New Millennium, good ol' magnets. What a concept! To think there were hippies using them in the 70's.
;)
Posted by velaguff on July 27, 2002, at 18:18:14
In reply to Re: Transcranial Magnetic Stimulation anyone?, posted by deli on July 27, 2002, at 16:47:27
This won't mean much if you're not into Ren and Stimpy, but it seems likely to me that Stimpy's Patented Stuponitron Helmet probably used the Transcranial Magnetic Stimulation principle (Stimpy probably shredded the patent to use as kitty litter one day when he was too desperate to go to the store). That device apparently only produced stupidity, rather than relief from depression (and yet, they say ignorance is bliss). I suspect the magnets in the helmet were slightly misaligned :)
Posted by LostBoyinNC1 on July 27, 2002, at 21:27:02
In reply to Transcranial Magnetic Stimulation anyone?, posted by deli on July 27, 2002, at 14:04:17
>
> Hello Everyone,
> I am back after a short relapse with my tears saturated pillows and blanket. I had my monthly visit with my enchanting pdoc (Oh, how I love to visit!) Anyways, we decided to continue on with the same concoction of Remeron, Prozac and Topamax. During our unusual conversation and I say unusual because the last few months all I do in his office is sob, I asked him about TMS.
> He said that the research on it seemed promising. He then later added that our University was presently conducting research through the Department of Psychiatry and the Brain Institute.
> I asked him if I should volunteer for the research and he was open to the idea. Anyway, I called and had a preliminary interview over the phone and got an appointment to meet with the psychiatrist conducting the study, for a two hour evaluation. After that, if they determined that I qualify for the study ( I guess am depressed enough) they will perform a battery of tests including pet scan, cat scan, mri, ekg, full physical and cognitive testing to rule out any physical condition. ( how cool is that; that's what I've tried doctors to do all my life)So I am going to be one of their guinea pigs.
> Apparently, TMS is a safer version of ect in that it causes no memory loss and no anesthesia is needed. I don't know anyone that has had it done. So I am sharing this with you in the event someone knows of this treatment and can shed some light on it.
> P.s. Yes, Topamax would be discontinued if I participate in the study.
>
> Love
> Deli;)
I dont know where your Pdoc got his info from, but the research on rTMS for severe depression is NOT promising. At least not compared to conventional ECT. I had rTMS in a clinical trial and it has some mild AD effects but it was nothing great. No side effects, but not a good AD effect either.The good thing about the study is you will get a lot of expensive medical testing done you otherwise wouldnt get. You will get a great free physical out of it. If you dont have to travel and stuff it might be worth it just for that. However, if you have to travel, pay hotel expenses, Id recommend forgetting about rTMS and just going and having old fashioned ECT instead.
ECT results are more dramatic and nothing creates a full remission better than bilateral or bifrontal ECT. Nothing works better on psychotic depression, severe post partum depression or manic depression than ECT.
Posted by deli on July 27, 2002, at 23:05:26
In reply to Re: Transcranial Magnetic Stimulation anyone?, posted by velaguff on July 27, 2002, at 18:18:14
> This won't mean much if you're not into Ren and Stimpy, but it seems likely to me that Stimpy's Patented Stuponitron Helmet probably used the Transcranial Magnetic Stimulation principle (Stimpy probably shredded the patent to use as kitty litter one day when he was too desperate to go to the store). That device apparently only produced stupidity, rather than relief from depression (and yet, they say ignorance is bliss). I suspect the magnets in the helmet were slightly misaligned :)
Well, fortunately my thirteen year old daughter was in the room and saw the words Ren and Stimpy and knew that I couldn't possibly know what that was. So she told me about it.
You see even nickelodeon knew about this!!!!
;)
Posted by deli on July 27, 2002, at 23:20:44
In reply to Re: Transcranial Magnetic Stimulation anyone?, posted by LostBoyinNC1 on July 27, 2002, at 21:27:02
> >
> >
> >
>
>
> I dont know where your Pdoc got his info from, but the research on rTMS for severe depression is NOT promising. At least not compared to conventional ECT. I had rTMS in a clinical trial and it has some mild AD effects but it was nothing great. No side effects, but not a good AD effect either.
>
> The good thing about the study is you will get a lot of expensive medical testing done you otherwise wouldnt get. You will get a great free physical out of it. If you dont have to travel and stuff it might be worth it just for that. However, if you have to travel, pay hotel expenses, Id recommend forgetting about rTMS and just going and having old fashioned ECT instead.
>
> ECT results are more dramatic and nothing creates a full remission better than bilateral or bifrontal ECT. Nothing works better on psychotic depression, severe post partum depression or manic depression than ECT.
>Well, I really thought so. I am more in it for the physical. My meds are beginning to work and I am beginning to feel better so I am really not as bad as I was a month ago. I have never had to resort to ECT yet. (keep my fingers crossed)But I think, if I go through yet another episode, I may just need it, because they just get more brutal with time.
I haven't made up my mind completely. I think once I have my appointment with the research doctor, I will decide. Thank you for your reply!!
Deli;)
Posted by LostBoyinNC1 on July 28, 2002, at 0:23:48
In reply to Re: Transcranial Magnetic Stimulation anyone?, posted by deli on July 27, 2002, at 23:20:44
>
> Well, I really thought so. I am more in it for the physical.I can understand that. Id be in it just for the PET scan hehehe. Basically it sounds like they want to do functional neuroimaging of your brain to determine what parts are active and not active and learn more about the specifics of your mental illness. This type of imaging technology is experimental like rTMS and hasnt yet filtered down to regular clinical psychiatry yet. However, unlike the rTMS, this functional neuroimaging technology can be very helpful to some people with mental illness as it can help give doctors a better, less subjective idea of whats exactly wrong with you.
However keep in mind that for a PET or SPECT scan they generally require you to have been off all meds for at least two weeks. If you are doing well now, it doesnt make much sense to go off your meds. Also, those rTMS trials are really more for refractorily depressed folks. Not for people whose meds are working good. So there is an ethical aspect of it here. If you were like "nothing works doc" and the drugs didnt work at all Id say it would be worth it, providing you didnt have to travel far. But its kind of unethical to try to get into an rTMS trial just to get a wham bam expensive physical and PET scan when youre doing OK. Just my personal opinion. Someone else who is not in good condition might need your rTMS slot a lot more than you need it.
>My meds are beginning to work and I am beginning to feel better so I am really not as bad as I was a month ago. I have never had to resort to ECT yet. (keep my fingers crossed)But I think, if I go through yet another episode, I may just need it, because they just get more brutal with time.
yeah, again ECT is ten times more effective than rTMS. No, make that a hundred times more effective. The PET scan part does sound attractive though LOL.
>
> I haven't made up my mind completely. I think once I have my appointment with the research doctor, I will decide. Thank you for your reply!!
> Deli;)Well, if your meds are working good Id say hold off. If your meds are not working then go for it. Even though I think you will find ECT in the end will probably fix your problem more effectively.
Actually, they have any trials where they do ECT with a PET scan? That would be a good deal.
Posted by Ritch on July 28, 2002, at 13:58:24
In reply to Transcranial Magnetic Stimulation anyone?, posted by deli on July 27, 2002, at 14:04:17
>
> Hello Everyone,
> I am back after a short relapse with my tears saturated pillows and blanket. I had my monthly visit with my enchanting pdoc (Oh, how I love to visit!) Anyways, we decided to continue on with the same concoction of Remeron, Prozac and Topamax. During our unusual conversation and I say unusual because the last few months all I do in his office is sob, I asked him about TMS.
> He said that the research on it seemed promising. He then later added that our University was presently conducting research through the Department of Psychiatry and the Brain Institute.
> I asked him if I should volunteer for the research and he was open to the idea. Anyway, I called and had a preliminary interview over the phone and got an appointment to meet with the psychiatrist conducting the study, for a two hour evaluation. After that, if they determined that I qualify for the study ( I guess am depressed enough) they will perform a battery of tests including pet scan, cat scan, mri, ekg, full physical and cognitive testing to rule out any physical condition. ( how cool is that; that's what I've tried doctors to do all my life)So I am going to be one of their guinea pigs.
> Apparently, TMS is a safer version of ect in that it causes no memory loss and no anesthesia is needed. I don't know anyone that has had it done. So I am sharing this with you in the event someone knows of this treatment and can shed some light on it.
> P.s. Yes, Topamax would be discontinued if I participate in the study.
>
> Love
> Deli;)Deli,
Here's a link to a discussion here about this last year:
http://www.dr-bob.org/babble/20010907/msgs/78799.htmlMitch
Posted by Dave1 on July 28, 2002, at 19:15:29
In reply to Re: Transcranial Magnetic Stimulation anyone?, posted by LostBoyinNC1 on July 28, 2002, at 0:23:48
Hi to anyone interested:
I've talked to a few key doctors involved with magnetic research. One said that even if you got some remission they still don't have maintenance treatments of rTMS. So even if you got remission with the rTMS, there is a good chance your remission would be short lived.
Another researcher told me that he didn't think rTMS was going to pan out, but he didn't elaborate.
I've also read that alot of doctors in this field think you need a seizure to get anti-depressant effects.
Bye,
Dave
Posted by deli on July 28, 2002, at 20:57:13
In reply to Re: Transcranial Magnetic Stimulation anyone?, posted by LostBoyinNC1 on July 28, 2002, at 0:23:48
> >
> > .
>
> I can understand that. Id be in it just for the PET scan hehehe. Basically it sounds like they want to do functional neuroimaging of your brain to determine what parts are active and not active and learn more about the specifics of your mental illness. This type of imaging technology is experimental like rTMS and hasnt yet filtered down to regular clinical psychiatry yet. However, unlike the rTMS, this functional neuroimaging technology can be very helpful to some people with mental illness as it can help give doctors a better, less subjective idea of whats exactly wrong with you.
>
> However keep in mind that for a PET or SPECT scan they generally require you to have been off all meds for at least two weeks. If you are doing well now, it doesnt make much sense to go off your meds. Also, those rTMS trials are really more for refractorily depressed folks. Not for people whose meds are working good. So there is an ethical aspect of it here. If you were like "nothing works doc" and the drugs didnt work at all Id say it would be worth it, providing you didnt have to travel far. But its kind of unethical to try to get into an rTMS trial just to get a wham bam expensive physical and PET scan when youre doing OK. Just my personal opinion. Someone else who is not in good condition might need your rTMS slot a lot more than you need it.
>
> > Well, if your meds are working good Id say hold off. If your meds are not working then go for it. Even though I think you will find ECT in the end will probably fix your problem more effectively.
>
> Actually, they have any trials where they do ECT with a PET scan? That would be a good deal.
>
>
You're right. I am not about to discontinue my meds for anything. The coordinator I spoke with told me that only Topamax would have to be discontinued. I know it's strange because what kind of controlled study that would be. Who knows what new things they're trying now. About taking someone's place who may need it more, I will not lie to these people. If I feel better when they interview me, I will tell them. I hope that's the case. Seeing the way I have been feeling lately, I think my meds are beginning to do their magic, so I may not even qualify because I am too content. Darn!;)
Posted by LostBoyinNC1 on July 28, 2002, at 21:12:41
In reply to Re: Transcranial Magnetic Stimulation anyone?, posted by Dave1 on July 28, 2002, at 19:15:29
> Hi to anyone interested:
>
> I've talked to a few key doctors involved with magnetic research. One said that even if you got some remission they still don't have maintenance treatments of rTMS. So even if you got remission with the rTMS, there is a good chance your remission would be short lived.yep, so why bother with it?
>
> Another researcher told me that he didn't think rTMS was going to pan out, but he didn't elaborate.Uh...I think that researcher is correct. I dont think rTMS will ever pan out either. They might finally figure out some use for it someday. It might be a good tool to combat dysthymia (mild depression) in conjunction with therapy. But for major depression? Forget it.
>
> I've also read that alot of doctors in this field think you need a seizure to get anti-depressant effects.Yeah, thats the general consensus. Its the seizure thats the key to the whole thing. Its the seizure that causes the real brain changes which wipe out depression. rTMS doesnt cause a seizure so it doesnt seem to have much punch to it compared to ECT. Personally, I dont know why the money is being spent on rTMS because I believe the money could be spent better on other things.
Posted by shar on July 30, 2002, at 0:55:52
In reply to Re: Transcranial Magnetic Stimulation anyone?, posted by velaguff on July 27, 2002, at 16:04:06
>>Or if one had the freedom and the right equipment, could one administer one's OWN treatment?
I had exactly that thought when I first heard about this a while back. And I have a TON of magnets on my refrigerator. And, my brother in law could no doubt generate a low level electrical current in his workshop.....I'm convinced I'm on to something here. :)
And, next.....the poor woman's ECT...
Shar
Posted by jda1292 on July 30, 2002, at 21:15:38
In reply to Re: Transcranial Magnetic Stimulation anyone?, posted by velaguff on July 27, 2002, at 18:18:14
You are a riot!
PS - Don't Whiz on the Electric Fence!
> This won't mean much if you're not into Ren and Stimpy, but it seems likely to me that Stimpy's Patented Stuponitron Helmet probably used the Transcranial Magnetic Stimulation principle (Stimpy probably shredded the patent to use as kitty litter one day when he was too desperate to go to the store). That device apparently only produced stupidity, rather than relief from depression (and yet, they say ignorance is bliss). I suspect the magnets in the helmet were slightly misaligned :)
This is the end of the thread.
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