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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by ignored on October 9, 2002, at 0:17:42
I am desperate for really good, clear information on Repetitive Transcranial Magnetic Stimulation Treatment of Major Depression.
Does anyone here know a lot about it? Is there a really good web site about it?
I am especially interested in safety, pros vs. cons, etc.
Thank you so much!
Posted by Pfinstegg on October 9, 2002, at 19:49:57
In reply to Desperate for good info on Repetitive Transcran..., posted by ignored on October 9, 2002, at 0:17:42
Hi! Please don't feel Ignored! I am also interested in rTMS. It presently has a research-only status, but it sounds extremely promising. My psychiatrist said that she knew of two severely depressed treatment-resistant patients who had been treated with rTMS at NIH with good results. The safety is very good, memory loss has not been reported, and it much easier to endure than ECT; a few patients have had a seizure, but they tended to have family histories of epilepsy. The treatments are done daily over a period of 20 days. It has been used for unipolar, and to a lesser extent, bipolar depression. Patients who responded well show an increase in blood flow to the left prefrontal cortex, as well a change towards normal in the levels and turnover rates of serotonin and dopamine- the same things that are seen with any type of successful treatment for depression, whether by antidepressants or ECT.
It is supposed to act like a heart defibrillator, shocking the neurons into all firing at once, and in this way resetting the neurotransmitters so that they function normally. With what they know so far, it seems to be a short-term treatment- about 6 months-, but maybe this will change after they have had more years to do the research.
If you look up "rTMS Depression" on Google, there are about 1000 entries of varying levels of helpfulness; there are about 15 university centers doing research in the USA at present. The one which seemed the most informative to me was the study from Emory, which is known as a great center for all kinds of research into mood disorders. They reported that rTMS resulted in 64% "very much improved" or "much improved" depression in the patients they treated, who had averaged 7 AD failures each. Eight of the patients were also ECT failures.
I don't know how to put this in blue so you can just click on it, but the site is hsnews@emory.edu.
Hope this is sort of what you were looking for!
Pfinstegg
Posted by Pfinstegg on October 9, 2002, at 22:47:27
In reply to Re: Desperate for good info on Repetitive Transcran..., posted by Pfinstegg on October 9, 2002, at 19:49:57
Your question got me looking even further into rTMS, which had been in the back of my mind as a possible treatment, but it has moved right to the front, as I have found a study from Tasmania(!) showing that successful treatment with rTMS changes dexamethasone test non-suppressors into normal suppressors. This is very valuable information for me, as I am a complete non-suppressor with over-normal 24-hour cortisol levels. I hope this additional bit of information is useful for you; it shows how helpful a good question on Psychobabble can be! Thanks! I am now going to keep on looking into rTMS for myself, and would love to know if you decide to do it, and if you do, what happens. I'll let you know, too.
Pfinstegg
I don't know if some nice person changes this to blue or if it happens automatically, but here is the reference: www.ists.unibe.ch/Lit/99_dAlfonso.pdf
Posted by Dr. Bob on October 10, 2002, at 20:47:41
In reply to rTMS and cortisol- how can I resist another post?, posted by Pfinstegg on October 9, 2002, at 22:47:27
> I don't know if some nice person changes this to blue or if it happens automatically
The nice server changes it automatically -- under certain conditions:
http://www.dr-bob.org/babble/faq.html#links
Bob
Posted by ignored on October 11, 2002, at 19:30:27
In reply to Desperate for good info on Repetitive Transcran..., posted by ignored on October 9, 2002, at 0:17:42
There is an open study not too far away from me. I am very interested in it, as my depression seems to be medicine-resistant. I do get relief from the suicidal fantasies, but not much else.
What worries me about this study is:
1. You have to be medicine-free.
2. There is a definite possibility that you will receive sham (placebo) treatments.I would risk going off my meds if I knew I was getting some other form of treatment, but I don't see how it's worth it when I might very well get the sham treatments.
Those that get the sham treatments are entitled to a course of real treatments once the study is over, but I think that's like eight months later!
Say I was off my meds and getting the sham treatments and became suicidal. Then I'd have to go back on my meds and wait however many weeks for them to kick in.
I just don't know what to do.
Posted by pfinstegg on October 11, 2002, at 22:53:57
In reply to What worries me about the study..., posted by ignored on October 11, 2002, at 19:30:27
Yeah, that's just what worries me, too. Do you know exactly how long you have to be off drugs- how long before, and how long the duration of the testing period is- the ones I am looking at are 20 days of either sham or real treatment; you have to be off SSRIs for a month, but can keep taking mood stabilizers such as lithium. Then, after, if you have had sham, you are offered the real thing immediately. Is it really 8 months off medication before you get any treatment? That's a lot to ask of someone.
It's a big step to take- having to leave home and work as well as face a drug-free interval. I have found that the people you telephone about these trials are helpful and specific about answering questions, but I also find myself thinking that I am doing fairly well with my present regimen, and maybe can wait until it is not such a hassle. The treatment itself sounds good- all my other treatments have been kind of half-way measures, and the possibility of having all my neurons safely zapped into something approaching normality is very appealling! It is hard to know what to do...
pfinstegg
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