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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 37. This is the beginning of the thread.
Posted by Dan Perkins on November 9, 2004, at 21:26:02
Hello,
Has anyone had TMS b/f? If so, could you please describe the physical sensation of the treatment and how well it worked in treating your depression.
thx
Posted by linkadge on November 10, 2004, at 10:40:08
In reply to Transcranial Magnetic Stimulation (TMS), posted by Dan Perkins on November 9, 2004, at 21:26:02
I built my own TMS machiene. It was not painful, and I did experience improvement in mood.
Mainly sleep, apetite, and a significant brightening of vision and sound (For me it was like I was being woken up from a deep sleep.Infact I had never felt so awake in all my life.
Linkadge
Posted by Dan Perkins on November 10, 2004, at 14:55:04
In reply to Re: Transcranial Magnetic Stimulation (TMS), posted by linkadge on November 10, 2004, at 10:40:08
Not painful? Really? My treatment hurts like a bitch! Did you experience any twitching of muscles in your face? My forehead and eyebrow seems to twitch on the side of my face that the TMS machine is on.
> I built my own TMS machiene. It was not painful, and I did experience improvement in mood.
> Mainly sleep, apetite, and a significant brightening of vision and sound (For me it was like I was being woken up from a deep sleep.
>
> Infact I had never felt so awake in all my life.
>
>
> Linkadge
Posted by Cecilia on November 10, 2004, at 18:16:13
In reply to Re: Transcranial Magnetic Stimulation (TMS), posted by Dan Perkins on November 10, 2004, at 14:55:04
I had 20 TMS treatments last winter and it hurt A LOT, though the brochure claims it`s painless. I also had the eye twitching and watering. No effect on my depression, but a large weight loss in my wallet. Cecilia
Posted by konfuzed on November 10, 2004, at 18:18:36
In reply to Re: Transcranial Magnetic Stimulation (TMS), posted by linkadge on November 10, 2004, at 10:40:08
how did you build your machine?
Posted by linkadge on November 10, 2004, at 19:35:36
In reply to Re: Transcranial Magnetic Stimulation (TMS), posted by konfuzed on November 10, 2004, at 18:18:36
basically with a high powered acustic amplifier a manufactured electromagnetic coil, and sound generation software on the computer.
I can't give the specifics, because I'm not conviced what I did was safe :)
Linkadge
Posted by ravenstorm on November 10, 2004, at 20:41:36
In reply to Re: Transcranial Magnetic Stimulation (TMS), posted by linkadge on November 10, 2004, at 19:35:36
Who is doing your rTMS? Any results yet? I have heard it is painful. Can they give you anything for the pain?
Posted by Dan Perkins on November 11, 2004, at 9:10:47
In reply to Re: Transcranial Magnetic Stimulation (TMS) Dan Pe, posted by ravenstorm on November 10, 2004, at 20:41:36
It is painful. A cross between having a really thick rubber band pulled back far and snapped directly on your head and having maybe 3-4 strands of hair yanked out at once.
Not sure if I have had any real results yet. I could theoretically (50% chance) be on a "sham" placebo treatment instead of receiving actual rTMS, but given the pain and muscle twitching I'm experiencing durring treatment, I'd be really surprised if I was not getting the real thing.
As far as the pain, they say that if you get a headache you can take any OTC pain releiver and that should help. I did read a post on psychobabble a while ago where someone said that taking tylenol 45 minutes b/f the treatment lessened the pain, so I'm going to try that today and see if it works.
Posted by ravenstorm on November 11, 2004, at 11:47:13
In reply to Re: Transcranial Magnetic Stimulation (TMS) Dan Pe, posted by Dan Perkins on November 11, 2004, at 9:10:47
OK, your in one of the trials. Let us know how it turns out for you. I too would be suprised if you were in the sham group since you are having the pain.
If the rTMS does work for you, will you go back on AD's afterwards?
Posted by Dan Perkins on November 11, 2004, at 16:02:01
In reply to Re: Transcranial Magnetic Stimulation (TMS) Dan Pe, posted by ravenstorm on November 11, 2004, at 11:47:13
At this point in my life I have come to realize that I will always need some kind of ongoing treatment for my depression. Even if the rTMS works I will definately go back on antidepressants anyway. I think they may even encourage you to seek out other help after this study in the form of antidepressants even if the treatment is effective.
I haven't read anything about rTMS that indicates that it is a permanent fix for depression. I think it is considered more like ECT in that further maintenance sesssions are the norm.
> OK, your in one of the trials. Let us know how it turns out for you. I too would be suprised if you were in the sham group since you are having the pain.
>
> If the rTMS does work for you, will you go back on AD's afterwards?
Posted by Cecilia on November 12, 2004, at 2:27:19
In reply to Re: Transcranial Magnetic Stimulation (TMS) Dan Pe, posted by Dan Perkins on November 11, 2004, at 16:02:01
Yes, I think for those in trials the idea of a "sham" treatment is a joke, for me the pain was excruciating, especially at first (like having nails pounded in to my head) and there`s no way I wouldn`t have known I was getting the real thing if I`d been in a trial. Of course the same is true for drug trials, most people know whether they are getting the real thing because of the side effects. I did get real TMS as I went up to a clinic in Canada. It didn`t help but I suppose I`m glad I did it, if I hadn`t I`d still be wondering if it might have worked. Cecilia
Posted by Dan Perkins on November 12, 2004, at 6:18:07
In reply to Re: Transcranial Magnetic Stimulation (TMS) Dan Pe, posted by Cecilia on November 12, 2004, at 2:27:19
> Yes, I think for those in trials the idea of a "sham" treatment is a joke, for me the pain was excruciating, especially at first (like having nails pounded in to my head) and there`s no way I wouldn`t have known I was getting the real thing if I`d been in a trial.
Yeah, for this to be a sham treatment, they would have had to modify the machine to somehow inflict a good deal of pain on me and to induce muscle twitching w/o using magnets. The technician also always takes a long time to make sure I'm positioned just right, which I don't think he would bother doing if he thought I was on the sham.
Posted by Pfinstegg on November 12, 2004, at 11:07:09
In reply to Re: Transcranial Magnetic Stimulation (TMS) Dan Pe, posted by Dan Perkins on November 12, 2004, at 6:18:07
I had an initial three week course of TMS in 2003, and have had three follow-up treatments of six treatments each. It hurt a LOT! i was given Tylenol #3 (codeine) to take 45 minutes prior, and that helped a lot. Each time, I had a real remission, which lasted several months. It's not permanent, though- you do need to keep on doing it. I had it to the left side, at a frequency of 20, and at 110% of the motor threshold. How are you getting it? If it is approved soon, i plan to continue it on a regular basis, if I need it. Right now, I've been in pretty good remission for six months without any further treatments, and I have to travel pretty far to obtain it. If it works for you, it's a wonderful side-effect-free treatment. It's supposed to do all the good things- decrease cortisol, increase blood flow to the LH, normalize all three main neurotransmitters, and increase cell growth in the hippocampus.
Posted by Dan Perkins on November 12, 2004, at 11:57:01
In reply to Re: Transcranial Magnetic Stimulation (TMS) Dan Pe » Dan Perkins, posted by Pfinstegg on November 12, 2004, at 11:07:09
Good to hear from you, Pfinstegg, I have read some of your earlier posts on TMS.
This is what I can tell you about my treatment:
I go 5 days a week (M-F) for a six week period.
I looked at the machine today and it said 10hz (or mhz?), which is I guess what you mean by frequency. Each train (that, apparently is the technical term for the series of magnetic pulses) lasts 4 seconds and there is 26 seconds between each train. A total of 75 trains are given each session.I was really surprised how much it hurt the first time. I have since started taking a pain reliever 45 minutes before each treatment (which is an idea I got from reading one of your posts). I took regular Tylenol (no codeine, unfortunately) yesterday and that worked OK, and then I tried Advil today which seemed to work a bit better. It still hurts but I can actually zone out now and think about other things and not really get bothered by each train.
I have had 5 treatments (out of a total of 30) thus far and It's a bit hard for me to tell if there has been any improvement. I have been in a deep depression for months but the problem is that I was feeling a good deal better the week before I started treatment and that feeling seemed to carry over into this week when my treatment started, so I can't tell yet how much to credit the actual TMS.
When you say that you go into remission after your sessions, does that mean you are depression free without antidepressants or are you taking ADs as well. The plan for this study is that if the treatment is effective after the 6 weeks, they put you on a maintenance level of an antidepressant and possibly offer you retreatment with TMS if depression returns.
If ther is no improvement after 6 weeks, they give you the option of continuing with the "real" TMS
treatment for an additional 6 weeks (I say "real" because it is a double blind study and half the people are receiving "sham" treatments in the initial 6 weeks - given the pain I'm pretty friggin' sure I'm not in the sham group).Good to hear all that stuff about the positive effects on cortisol, etc. that you mention. I hadn't hear or read any of that before.
I hope this works for me as well as it's worked for you. I guess only time will tell.
> I had an initial three week course of TMS in 2003, and have had three follow-up treatments of six treatments each. It hurt a LOT! i was given Tylenol #3 (codeine) to take 45 minutes prior, and that helped a lot. Each time, I had a real remission, which lasted several months. It's not permanent, though- you do need to keep on doing it. I had it to the left side, at a frequency of 20, and at 110% of the motor threshold. How are you getting it? If it is approved soon, i plan to continue it on a regular basis, if I need it. Right now, I've been in pretty good remission for six months without any further treatments, and I have to travel pretty far to obtain it. If it works for you, it's a wonderful side-effect-free treatment. It's supposed to do all the good things- decrease cortisol, increase blood flow to the LH, normalize all three main neurotransmitters, and increase cell growth in the hippocampus.
Posted by Pfinstegg on November 12, 2004, at 14:02:13
In reply to Re: Transcranial Magnetic Stimulation (TMS) Dan Pe, posted by Dan Perkins on November 12, 2004, at 11:57:01
Good to hear from you, too! You are just at the very beginning, and you are having it at a slower rate than I did. For me, each treatment was 400 trains. You are having an intermediate frequency, which is the newest way to do it. (It used to be given either at a low frequency of 2 mHerz or a fast one of 20 mHerz). I don't think you'll know whether it's really beneficial for a couple of weeks at least. Isn't is typical for them to reassure everyone that it doesn't hurt, when it REALLY does? It's like the drug companies slowly and reluctantly admitting to side effects after they have become generally known to the people taking their drugs.
I have typically had a "drug holiday" for several weeks after the TMS, because I felt so well then. The depression would slowly return, however, ahd I have usually taken low doses of Lexapro 5-10 mg.) and Wellbutrin (37.5- 75 mg. of the regular release) as maintenance. More recently, perhaps because of the intensive psychotherapy I have undertaken, I'm much less deprssed in general, so I take the low dose Wellbutrin plus tianeptine. I just chose the latter on my own, because it is so neuroprotective in animals- it's not much of an antidepressant, but from what I've read of it, I feel it might protect me from another severe depressive episode. Just guessing here! I do think the Wellbutrin is definitely helpful for people who have taken a lot of SSRI's, as it does tend to raise dopamine.
I wish you the very best of luck, and do hope you find it helpful. Even if you don't find much improvement in depression ( I hope you do!), it is likely to be helpful over-all to your brain's functioning, and it might help the AD's work better afterwards.
Are you taking it as part of one of the Neuronetics trials? I've read that they are conducting them at about 20 centers, in the hope of gaining FDA approval in late 2005.
Posted by Dan Perkins on November 12, 2004, at 18:17:32
In reply to Re: Transcranial Magnetic Stimulation (TMS) Dan Pe, posted by Pfinstegg on November 12, 2004, at 14:02:13
It is indeed a Neuronetics trial. How do you know so much about this topic? I have done some research and read a number of articles, but you seem to know a lot of stuff that I haven't come across.
It seems sort of arbitrary how many trains they do, etc. I don't understand why they do this 4 seconds on 26 seconds off regimen with me. I hope there is some logic to it b/c it would he nice to take 15 seconds off of that interval time and cut each session time in half, or even better, double the number of trains. It would seem to me that more would be better. Strange.
Posted by Shalom34Israel on November 12, 2004, at 19:16:34
In reply to Transcranial Magnetic Stimulation (TMS), posted by Dan Perkins on November 9, 2004, at 21:26:02
> Hello,
>
> Has anyone had TMS b/f? If so, could you please describe the physical sensation of the treatment and how well it worked in treating your depression.
>
> thxI had rTMS in Israel years ago in experiment. Results were poor. I do not recommend rTMS, I recommend ECT. ECT works, rTMS is weak. It felt like a woodpecker pecking on your forehead and was loud, must wear earplugs. No real side effects, very minimal effects of any kind.
Shalom
Posted by Pfinstegg on November 12, 2004, at 20:54:56
In reply to Re: Transcranial Magnetic Stimulation (TMS) Dan Pe, posted by Dan Perkins on November 12, 2004, at 18:17:32
Well, I've probably been googling it longer than you have! Also, the doctor who gave it to me, Dr. Mark Hutto of Atlanta, was a wonderful source of information, and loved to give me reprints about it. He's got a large number of patients who have been helped by it, and who come to Atlanta from all over for maintenance. It's been helpful in about 64% of the people he has tried it on.
He always says that ECT is a more powerful treatment than TMS. For the people who need ECT, he starts there, but tries to switch them to TMS once they are better, as memory isn't affected, and quality of life and safety is so much greater.
Be sure to let us know how your trial proceeds. And best of luck!
Posted by B2Chica on November 14, 2004, at 17:19:34
In reply to Transcranial Magnetic Stimulation (TMS), posted by Dan Perkins on November 9, 2004, at 21:26:02
wow, i just watched this thing on the natl'geographic channel (or disc. chnl...)anyway, JUST TODAY about sleep deprivation (one of my issues). but they were talking about it's study in using TMS as a way to help people stay awake longer without the negative effects! their example were soldiers.
now i'm curious about this TMS and what/how it effects the brain. (electrically and such-what is stim's and side effects and how accurate can they be?-how stimulating one area may effect another??)
B2c.
Posted by Shalom34Israel on November 14, 2004, at 20:06:35
In reply to Re: Transcranial Magnetic Stimulation (TMS) Dan Pe, posted by Cecilia on November 12, 2004, at 2:27:19
rTMS is getting poor reviews for treatment of refractory depression. It will never equal ECT in effectiveness, particularly for severe depression or psychotic depression. Much money is being wasted on rTMS studies that could be used elsewhere, plus it leads on many many depressed people thinking it will work when it doesnt.
I know so because I had rTMS several years ago (study) and it was very poor in results. Also, the scientists who are studying it are even saying it doesnt work that well. Dr. Mark George, the American super psychiatrist at MUSC says it has mild effects on major depression. In a Scientfic American article he authored last year, he said the present rTMS is not effective for refractory depression because it only penetrate the outer cortex of the brain.
Get ECT instead. ECT work. rTMS is sham.
Excuse my rough English.
Shalom
Posted by Dan Perkins on November 17, 2004, at 22:32:40
In reply to Re: Transcranial Magnetic Stimulation (TMS) Dan Pe » Dan Perkins, posted by Pfinstegg on November 12, 2004, at 20:54:56
I'm a week and a half into 6 weeks of my TMS study. I've started taking 2 Advil an hour b/f the procedure to help with the pain, but it still hurts like HELL.
I have noticed an elevation in my mood since starting treatment, but I'm still really depressed. Hoping things continue to improve and start to make a dent on my real depression.
There was a 50% chance in this study that I would be put on a sham (placebo) treatment but I know I'm getting the real thing. I realized that for this to be a sham treatment that would mean that I am hooked up to a machine that is somehow inflicting a lot of pain and the occasional headache on me, which seems to be the only reported side effects of TMS. I'm pretty sure that it would be unethical to give a study participant a placebo treatment that only mimics the negative effects of the real treatment.
Posted by denise1904 on November 18, 2004, at 6:33:00
In reply to Re: Transcranial Magnetic Stimulation (TMS) Dan Pe, posted by Dan Perkins on November 17, 2004, at 22:32:40
Hi,
I travelled all the way from the UK to Vancouver to try this treatment, had 30 sessions and have to say that it did not work for me at all, it was uncomfortable but I would have taken as much pain as possible if I thought it would have helped my depression. I even tried to get the guy who was doing it to increase the stimulus.
But even though it didn't work for me, I doestn't mean to say it won't work for others. Afterall 10 years ago I would have sworn blind that SSRIs worked brilliantly and within days to everyone, because they did work so well for me. Now though If this had been my first time taking them and I had no previous experience of how effective they can be I would be saying how they don't really work that well.
So you can never be sure.
Denise
Posted by glenn on November 20, 2004, at 11:26:09
In reply to Re: Transcranial Magnetic Stimulation (TMS) Dan Pe, posted by denise1904 on November 18, 2004, at 6:33:00
Denise, sorry to hear your rtms did not help at all.
Like you I travelled "over there" (california) for an answer, luckily for me I got the perfect one from Dr Jensen.
If there is any way I can help ( have loads of info on drug/ alternative, supplemental ect methods, don't hesitate to get back.
Glenn
Posted by SLS on November 20, 2004, at 14:32:55
In reply to Re: Transcranial Magnetic Stimulation (TMS) Dan Pe, posted by glenn on November 20, 2004, at 11:26:09
> Denise, sorry to hear your rtms did not help at all.
>
> Like you I travelled "over there" (california) for an answer, luckily for me I got the perfect one from Dr Jensen.
>
> If there is any way I can help ( have loads of info on drug/ alternative, supplemental ect methods, don't hesitate to get back.
>
> Glenn
Hi Glenn.If you don't mind my asking, what condition do you suffer from and what treatments are you currently finding success with?
I have a bad case of bipolar depression that remains inadequately treated.
Thanks.
- Scott
Posted by Dan Perkins on November 28, 2004, at 17:52:37
In reply to Re: Transcranial Magnetic Stimulation (TMS) Dan Pe, posted by SLS on November 20, 2004, at 14:32:55
Update
I have now completed 15 sessions of TMS and have 15 left to go in the study that I am in. I seemed to get a little less depressed after the first week or so and my mood was slightly improved. This lasted till about the middle of this past week and now I can feel the depression coming back some.
All I know is that halfway through this study and after going through a number of TMS treatments, I don't think I am improved more than I tiny bit (if at all).
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