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Tuesday July 22nd 2014

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New Therapy Zaps the Blues

by Jeremy Morrison

At first glance, it looks a lot like a dental chair. Then you notice the part of the machine that’s dangling overhead. That’s the apparatus that sends magnetic fields into the frontal lobe of your brain.

“It’s basically going to depolarize the neurons in the brain in the prefrontal cortex,” says Kelli Walker, MS, a mental health worker with The Anchor Clinic in downtown Pensacola. “It’s really awesome.”

On the clinic’s third floor office complex, sits the sleek, clinical chair that Walker calls her “baby.” The device, a NeuroStar TMS Therapy System, was approved by the U.S. Food and Drug Administration in 2008. It’s used for the treatment of depression.

The acronym TMS is probably not a familiar one, as the technology has just recently gained visibility. It stands for transcranial magnetic stimulation, and it’s exactly what it sounds like.

According to Neuronetics, the company that makes the NeuroStar system, the process involves sending tiny electrical currents into the brain in hopes that it will increase the levels of neurotransmitters and thus relieve symptoms of depression. The treatment is approved for adults who are not having success with one or more antidepressant medications.

It sounds strange. Something from the future or outer space. Walker assures that the concept of using electromagnetic stimulation on the brain has been around for decades, but only recently been approved for use to treat depression.

Walker said that, at first glance, the idea of zapping your brain may seem “sci-fi, or weird,” but that people who have found no relief for their depression to date may want to take a second look.

“If you’ve been depressed for 20 years, if you’ve been taking medications for 20 years,” she proffers, “why not try something else?”

In the simplest terms, doctors currently believe that depression is caused by an imbalance of certain chemicals in the brain. Attempts to alleviate the symptoms of depression are essentially attempts to balance out those chemicals.

“Medication does attempt to do that,” said Walker. “More often than not, poorly.”

Seated behind an office desk, Anchor’s TMS Coordinator takes out a binder. From within the binder, she pulls out a flow chart and places it on the desk. Walker points to the chart and runs her finger down a list of antidepressant medications.

There are plenty of them. Celexa, Lexapro and Prozac. And Luvox, Paxil or Zoloft. How about Wellbutrin? Maybe some Cymbalta, Effexor, Pristiq, Edronax, Remeron or Trazadone?

“And the medications may or may not work,” Walker warns, before moving her finger over to another long list.

To the side of the flow chart is a list of possible side effects from antidepressants. It reads like a smorgasbord of things to avoid, things that could be quite depressing themselves.

Possible side effects from the myriad of antidepressant medications include diarrhea, nausea, insomnia and constipation. Also nervousness and anxiety, abnormal ejaculation, impotence and decreased sexual interest. Or you could experience weight gain, and increased or decreased appetite. Medications could also cause weakness and fatigue, dry mouth or dizziness, and possibly sweating or tremors.

Walker said that TMS therapy does not have any side effects, except for some reports of a mild headache. She didn’t expect the pharmaceutical companies to be too keen on the practice once it caught on.

“They’re going to hate it,” Walker said about the pharmaceutical companies. “They’re goning start losing money like crazy on medication. That’s their problem.”

Currently, TMS therapy is not a realistic option for many patients. The service, which cost upwards of $10,000 for a six-week treatment, is not covered by most insurance companies.

“We would have people lined up around the street if their insurance would cover it,” Walker said, adding that she suspected the practice would soon be covered. “As soon as insurance kicks in we’re probably going to have to buy five machines.”

In addition to lacking side effects and being relatively affordable (in comparison to years on medications), the NeuroStar treatment reportedly works. According to Walker, patients experiencing no success with medications have seen improvements after undergoing magnetic-wave sessions.

But what is considered a successful run in the TMS chair? Cured?
“That’s patient-specific,” says Walker, explaining that she has seen people fully recover and drop all their meds, and she’s seen patients simply reach a coping point, but feels the therapy has been overall useful in treating depression within the clinic.

With the machines being somewhat of a novelty, a few doctors in the clinic gave them a spin to see what the ride was like. No one sat through a full session, just a small taste.

“I wanted to know how it felt,” Walker says. “It didn’t hurt.”

She compared the experience to being thumped in the head. The process is reportedly loud and “annoying.” She said men seemed more bothered by the transcranial magnetic stimulation than did women.

“If you can handle being thumped on the head for six weeks and come out a different person,” Walker says, “it’s totally worth it.”