November 27 , 2007 Penn Research Shows Transcranial Magnetic Stimulation Effective in Treating Major Depression Non-drug, non-invasive treatment helps patients who have tried other options without success.
PHILADELPHIA – 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.”
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

References and Links

• “Man ‘roused from coma’ by a magnetic field” 15 October 2008 NewScientist.com news service at http://www.newscientist.com/article/mg20026783.400-man-roused-from-coma-by-a-magnetic-field.html
• “Enhancing savant like creative abilities with TMS” at http://query.nytimes.com/gst/fullpage.html?res=9506EFD81538F931A15755C0A9659C8B63
• “Autism and hyperactivity helped by transcranial magnetic stimulation” at University of Louisville, Kentucky Autism News by Matthew Hogg Monday, 14 April 2008 at http://www.ei-resource.org/news/autism-news/autism-helped-by-transcranial-magnetic-stimulation
• Maintenance Treatment With Transcranial Magnetic Stimulation in a Patient With Late-Onset Schizophrenia (hallucinations were greatly improved, by 80%) by EMMANUEL POULET, M.D., Ph.D., JEROME BRUNELIN, Ph.D., LASSAD KALLEL, M.D., THIERRY D’AMATO, M.D., Ph.D., and MOHAMED SAOUD, M.D., Ph.D., Lyon, France and Bron, France Am J Psychiatry 165:537-538, April, 2008 American Psychiatric Association
• “Portable device effective in zapping away migraine pain” Ohio State University Medical Center 26-Jun-2008 at http://www.eurekalert.org/pub_releases/2008-06/osum-pde062508.php
• Transcranial Magnetic Stimulator Claims To Zap Away Migraines, Submitted by News Account on 25 June 2008 – 7:30am.Psychiatry . “Stimulation with magnetic pulses from the portable TMS device proved effective for the migraine patients” at scientificblogging/transcranial_magnetic_stimulator_claims_to_zap_
  away_migraines
• Magnetic Brain Stimulation for Sleepiness, Memory Impairment, Anxiety Disorders and Schizophrenia(As the researchers wrote in the journal Cerebral Cortex, “TMS recipients were speedier in memory tests following the treatment” at Columbia University (funded by the Department of Defense).
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• Efficacy of TMS on Depression (with 53 references) in J. Psychiatry Neurosci 2005; 30(2) by Dr J. L. Couturier at http://www.cma.ca/multimedia/staticContent/HTML/N0/l2/jpn/vol-30/issue-2/pdf/pg83.pdf
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• Handbook of Transcranial Magnetic Stimulation, edited by Alvaro Pascual-Leone, Nick Davey, John Rothwell, Eric Wasserman, and Basant K. Puri. Oxford University Press, New York NY 2002.
• Educational Video on Transcranial Magnetic Stimulation (patient says “I feel like superman afterwards; better sleeping, appetite, energy, motivation, optimism”) from Fuqua Center For Late-Life Depression at Emory University at http://www.emoryhealthcare.org/departments/fuqua/patient_info/TMS.html

1. Publications on treatment of “Depersonalization” using Transcranial Magnetic Stimulationfrom a clinical trial to evaluate the clinical efficacy of transcranial magnetic stimulation in the treatment of Depersonalization Disorder (DPD) Strong electromagnetic fields generated briefly (~1ms) but repetitively (1 to5 Hz) applied for 30mins, in five sessions per week for up to twelve weeks at http://clinicaltrials.gov/ct2/show/NCT00529217?cond=%22Depersonalization%22&rank=1
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14. Wassermann EM. Risk and safety of repetitive transcranial magnetic stimulation: report and suggested guidelines from the International Workshop on the Safety of Repetitive Transcranial Magnetic Stimulation, June 5-7, 1996. Electroencephalogr Clin Neurophysiol. 1998 Jan;108(1):1-16.
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