When patients do not respond to drug or talk therapy treatments for depression, a clinic in Corte Madera is among those using another method — magnetic fields.
Jacqueline Perlmutter, an addiction specialist at the Mind Therapy Clinic in Corte Madera, said transcranial magnetic stimulation (TMS) uses magnetics instead of electricity to stimulate small regions of the brain that are underactive, stimulating neurotransmitters like serotonin, which can affect mood, social behavior, appetite, sleep, and more.
TMS is an outpatient procedure. The patient wears a magnetic stimulation device on their head, and the device is monitored by a computer that uses precisely targeted magnetic pulses — similar to those used in MRI — to target predetermined areas of the brain, based on measurements gathered from brain imaging.
Patients are awake and alert during treatments which last about a half hour, and can resume normal activities afterwards.
They typically receive one treatment each day, five days a week for two to six weeks.
Americans spend billions of dollars each year on antidepressants, but it is estimated that they work for only 60 to 70 percent of people who take them, according to the National Institutes of Health.
According to the World Health Organization, 16 million Americans report having a major depressive episode.
The number of people with depression has also increased 18 percent since 2005.
TMS was first developed in 1985 and was approved by the FDA in 2008. Though not completely mainstream, the treatment is covered by most insurances and is used by the Mayo Clinic, the Johns Hopkins Brain Stimulation Program, and several clinics throughout the North Bay including Brainefit, in Davis.
Brainefit is run by Medical Director Guohua Xia, a psychiatrist, researcher and associate professor at University of California, Davis. He was in on the ground floor to use TMS for research since 1988 and became a principal investigator for several international clinical trials later on to study the efficacy and safety of TMS for the treatment of brain disorders.
He was so impressed with the initial results and the potentials of the treatment, he tried to make a machine himself but “I was a young physician, not an engineer, and there was not enough funding...” he said.
TMS is also a safe alternative to electroconvulsive therapy (ECT), said Xia (pronounced ”Hsia”). ECT, formerly known as electroshock therapy and often referred to as shock therapy, electronically induces seizures in patients who are unresponsive to other therapies, to provide relief from severe mental disorders including treatment-resistant depression.
Side effects of ECT, however, can include memory loss and brain damage according to a widely publicized report from the University of Aberdeen, Royal Cornhill Hospital in the United Kingdom.
Unlike ECT, in which electrical stimulation is more generalized, TMS can be targeted to a specific region in the brain.
Side effects of TMS may include headache or scalp discomfort and in rare cases seizures. Sometimes a person may have discomfort at the site on the head where the magnet is placed. The muscles of the scalp, jaw or face may feel a buzzing, Perlmutter said.
Because the treatment is relatively new, long-term side effects are unknown.
While Xia has been a leading proponent of TMS since the beginning, he said there is margin for error.
Each patient is initially given treatment to the same area of the brain, but there are many variables depending on each patient. If one area of the brain doesn’t respond, another area could be tried.