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Topic Name: Penn research shows TMS is a safe and effective in treating major depression
Category: Biomedical
Research persons: John P. O’Reardon, MD.
Location: University of Pennsylvania, United States
Details
Researchers at the University of
Pennsylvania School of Medicine and other study sites have found that
transcranial magnetic stimulation (TMS) – a non-invasive technique that
excites neurons in the brain via magnetic pulses passed through the scalp – is
a safe and effective, non-drug treatment with minimal side effects for patients
with major depression who have tried other treatment options without benefit.
This study – the largest to-date studying TMS as a standalone treatment for
major depression – appears in the December 1st issue of Biological Psychiatry.
“TMS provides a well-tolerated treatment option to patients whose
depression is otherwise treatment resistant,” says John P. O’Reardon, MD,
Associate Professor of Psychiatry at Penn, and lead study author. “Since TMS
is administered via the scalp and therefore goes directly to the brain, it
allows the patient to avoid bodily side effects such as weight gain, sedation
and/or sexual function.”
The study was conducted at 23 sites in the U.S., Australia, and Canada, and
involved 301 medication-free patients with major depression who had not
benefited from prior treatment. The patients were randomized to active or sham
TMS for 4-6 weeks. Response and remission rates with active TMS were
approximately twice those of sham. Additionally, there were no unexpected,
serious side effects, and less than 5% of patients discontinued their TMS due to
side effects. This is about three times better tolerated and safer than standard
medications, which have about a 15% discontinuation rate due to side effects.
Dr. O’Reardon further comments, “As indicated by recent large scale,
government-sponsored, studies of existing treatment options for major depression
conducted by the National Institute of Health (the STAR-D reports), there is a
great need to develop new, effective treatments for patients, especially those
not benefiting from first line interventions. The results of this study indicate
that TMS offers new hope to patients in this regard.”
Note for Transcranial magnetic stimulation
Transcranial magnetic stimulation (TMS) is a noninvasive method to excite neurons in the brain. The excitation is caused by weak electric currents induced in the tissue by rapidly changing magnetic fields (electromagnetic induction). This way, brain activity can be triggered or modulated without the need for surgery or external electrodes. This is used to study the circuitry and connectivity of the brain.
Repetitive transcranial magnetic stimulation is known as rTMS and can produce longer lasting changes. Numerous small-scale pilot studies have shown it could be a treatment tool for various neurological conditions (e.g. migraine, stroke, Parkinsons Disease, dystonia, tinnitus) and psychiatric conditions (e.g. clinical depression, auditory hallucinations), but as yet no large scale trial has been done, the therapeutic potential of rTMS is not considered proven.
Additional study authors are H. Brent Solvason, Philip G. Janiak, Shirlene
Sampson, Keith E. Isenberg, Ziad Nahas, William M. McDonald, David Avery, Paul
B. Fitzgerald, Colleen Loo, Mark A. Demitrack, Mark S. George, and Harold A.
Sackeim.
Disclosure: Dr. O’Reardon has received grant support from BMS, Cyberonics,
Lilly, Magstim, Neuronetics, Pfizer, and Sanofi; acted as a consultant for Lilly
and Neuronetics; and is a member of speakers bureaus for BMS, Cyberonics, and
Lilly.
About Researcher
John P. O'Reardon, MD
Department of Psychiatry
Penn Behavioral Health
3535 Market Street
Philadelphia, PA 19104
1-800-789-PENN (7366)
Faculty Appointment:
Associate Professor of Psychiatry at the Hospital of the University of Pennsylvania
Educational Background:
Medical School: National University of Ireland
Internship: Hospital of the University of Pennsylvania
Residency: Hospital of the University of Pennsylvania
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