New procedure can help treat moderate depression

Q: I know magnets are used for different bodily problems, but can they be used to alleviate mental disorders?

There is a relatively new procedure known as Transcranial Magnetic Stimulation that is used to treat moderate depression when medication and psychotherapy aren't effective.

TMS was developed in 1985. It has been studied as a possible treatment for depression and other disorders since the mid-1990s. In October 2008, TMS was approved for use by the U.S. Food and Drug Administration as a treatment for major depression for patients who have not responded to at least one antidepressant medication. It is used in other countries such as Canada and Israel as a treatment for depression.

During TMS, doctors place an electromagnet against your head. The magnet creates electric currents that work on the part of your brain that is responsible for mood control. Scientists don't know how it works, but it appears that the stimulation changes how the brain functions.

More study about TMS is needed. Some research demonstrated that TMS relieved depression; other studies showed that it wasn't effective. Transcranial magnetic stimulation may be less likely to work if the depression has lasted for more than four years, or a patient is suffering from a break from reality.

TMS is usually an outpatient procedure. It can be done in a doctor's office. Treatments are done daily for about 40 minutes, five times a week for four to six weeks. They do not require anesthesia.

There are mild side effects that usually go away after a week of treatment. These include headache, tingling, feeling lightheaded and some scalp discomfort. Serious side effects are uncommon.

During a procedure, you usually sit in a comfortable chair such as a recliner. A magnetic coil is placed on your forehead. When the magnet is turned on, short pulses are administered through the coil. You will feel tapping and hear clicking. The magnetic field is similar to that used by a magnetic resonance imaging machine. When the treatment is completed, you can return to your normal activities.

The major advantages of TMS are safety and ease of treatment. The biggest drawbacks are that it doesn't help some patients; it can take several weeks to begin to work, and it is expensive. Treatments cost between $250 and $500 each.

The biggest barrier to getting TMS is concern about insurance coverage. As TMS becomes more firmly established, it's likely that insurance coverage will become more universal.

In my next column, I'll cover other brain-stimulation therapies.