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TMS Therapy

A FRESH APPROACH TO TREATING DEPRESSION

Abaris Behavioral Health now offers NeuroStar TMS Therapy which is a non-invasive, non-drug treatment that’s giving some depression patients a reason to smile

 

Depression: A serious illness 

Depression afflicts over 14 million American adults (about 6.7%) every year1.  Many go undiagnosed and untreated. The cost of untreated or unsuccessfully treated depression was estimated by the National Institute of Mental Health to be $83.1 billion in 20002; the cost to physical health, relationships, and enjoyment of life is incalculable. It’s important to recognize the symptoms and get treatment as soon as possible.

 

How do you know if you’re depressed?

A major depressive episode represents a change in the way a person feels and generally includes at least five of the following symptoms3:

  • Depressed mood
  • Markedly diminished interest or pleasure in usual activities
  • Significant change in weight and/or appetite
  • Insomnia or hypersomnia (sleeping too much)
  • Psychomotor agitation or retardation
  • Fatigue or loss of energy
  • Feelings of worthlessness or excessive or inappropriate guilt
  • Slowed thinking or impaired concentration
  • Recurrent thoughts of death or suicide

 

Women and depression

Women are twice as likely as men to suffer from depression.4

 

What causes depression?

The exact cause is unknown. However, the best scientific theory is that depression is caused by a chemical imbalance in the brain. The chemicals involved are called neurotransmitters, which carry signals between brain cells.

 

What helps?

Antidepressant medications are designed to increase the levels of neurotransmitters, thereby restoring proper balance and enhancing mood.

The problem is, these medications don’t work for everyone. More than 4 million depression patients who take antidepressant medications see little or no benefit.5 If your depression treatment is not working for you, read on. NeuroStar TMS Therapy may be just what the doctor will order.

 

What is NeuroStar TMS Therapy?

tms-therapy-chairTMS stands for Transcranial Magnetic Stimulation. It’s a medical treatment that can be performed in a psychiatrist’s office.

While you sit back in a comfortable chair, the TMS treatment coil delivers focused magnetic pulses that stimulate an area of the brain thought to be involved with regulating mood. The magnetic field is similar to that used in magnetic resonance imaging (MRI) machines.

The NeuroStar TMS Therapy system is the only TMS device cleared by the Food and Drug Administration (FDA) for the treatment of depression in patients who have failed to benefit from prior antidepressant medication.

 

NeuroStar TMS Therapy is indicated for the treatment of Major Depressive Disorder in adult patients who have failed to achieve satisfactory improvement from one prior antidepressant medication at or above the minimal effective dose and duration in the current episode.  It is available by prescription only.

 

What are the benefits?

TMS Therapy® is a non-invasive outpatient treatment that requires no surgery or anesthesia. TMS Therapy is non-systemic, meaning that no substances enter your bloodstream that can affect other parts of your body. Each session takes only about 37 minutes and allows you to go right back to your normal activities.

 

How effective is it?

In a clinical trial, where patients received either active NeuroStar TMS Therapy or inactive treatment, patients treated with active NeuroStar TMS Therapy experienced an average reduction in their depression symptom score of 22.1% compared to a 9% reduction in patients receiving inactive treatment.6

In a follow-on study, where all patients received active NeuroStar TMS Therapy treatment, the following results were observed after six weeks7:

  • 1 in 2 patients showed clinically significant improvement.
  • 1 in 3 patients experienced complete symptom relief.

Patients also noticed significant relief from anxiety and physical symptoms, like appetite changes, aches and pains and lack of energy that are often associated with depression.

NeuroStar TMS Therapy has not been studied in patients who have not received any prior antidepressant treatment. Its effectiveness has not been established in patients who have failed to receive benefit from two or more prior antidepressant medications at minimal effective dose and duration in the current episode.

How safe is it?

NeuroStar TMS Therapy is the only FDA-cleared TMS device for the treatment of depression.  Over 10,000 active treatments were performed during clinical trials demonstrating its safety8.

NeuroStar TMS Therapy may not be right for everyone; ask your doctor if NeuroStar TMS Therapy may be right for you.  For more information on the safety and effectiveness of NeuroStar TMS Therapy or to locate a NeuroStar TMS Therapy provider in your area, visit www.NeuroStar.com.

 

Are there any side effects?

Treatment with NeuroStar TMS Therapy has few side effects and is generally well tolerated by patients. The most common side effects reported during clinical trials were headache and scalp pain or discomfort at the treatment site, which were generally mild to moderate and occurred less frequently after the first week of treatment8.  There were also none of the systemic side effects that are associated with antidepressant medications 6.  There is a rare risk of seizure with TMS Therapy.  As with all antidepressant therapy, patients should be monitored for signs and symptoms of worsening depression.

 

tms-therapy-wandHow does it work?

The treatment coil is placed on the left side of the head above the prefrontal cortex. This is the part of the brain that is thought to affect mood and where NeuroStar TMS Therapy is focused.  The magnetic field generated by the NeuroStar TMS system activates nerve cells that are known to release chemicals called neurotransmitters. 9 The theory behind TMS Therapy is that increasing the levels of these neurotransmitters can alleviate the symptoms of depression.

 

Who is eligible?

In each case, a physician should perform a complete evaluation of the person’s medical and psychiatric history to determine whether NeuroStar TMS Therapy is recommended. If NeuroStar TMS is an appropriate treatment option, a psychiatrist will provide a prescription for TMS Therapy.

NeuroStar TMS Therapy is appropriate for adult patients with Major Depressive Disorder who have failed to achieve satisfactory improvement from one prior antidepressant medication at or above the minimal effective dose and duration in the current episode.

NeuroStar TMS Therapy is contraindicated in patients with implanted metallic devices or non-removable metallic objects in or around the head. Patients with braces and metal fillings are acceptable for treatment.

 

How much therapy would I need?

The initial course of treatment requires 20-30 treatments over a 4-6 week period. Treatments are administered five days a week and each session takes 37 minutes.

 

Does insurance cover it?

NeuroStar TMS Therapy may be covered on a case-by-case basis. You can work with your doctor and the NeuroStar Care Connection (NCC) program to seek case-by-case coverage. The NCC staff is made up of trained case managers that can help you and your doctor with the reimbursement process.

In the mean time, out-of-pocket payment may be required. NeuroStar TMS Therapy can be paid from healthcare flexible spending account. Clark Behavioral Health Financing can also help you develop a financing plan as needed.  They can be reached at 888-755-3080 or you can visit their Web-site: www.ClarkBHF.com.

 

 

 

References:

1. Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 2005 Jun; 62(6):617-27.

2. Greenberg, PE, et al. The economic burden of depressive disorders in the United States: How did it change between 1990 and 2000? Journal of Clinical Psychiatry. 2003; 64 (12): 1465-1475.

3.  American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000.

4.  Kessler, RC.  The Epidemiology of Women and Depression.  Journal of Affective Disorders, 2003 Mar: Vol. 74, Issue 1, Pages 5-13

5. Kessler, RC, et al. The Epidemiology of Major Depressive Disorder – Results from the National Comorbidity Survey Replication (NCS-R). JAMA, 2003 Jun: Vol. 289, No.23.

6.  Data on File.

7.  Demitrack, M.A., Thase, M. (2009) Clinical Significance of Transcranial Magnetic Stimulation (TMS) in the Treatment of Pharmacoresistant Depression: Synthesis of recent data. Psychopharmacology Bulletin, Vol 42, No. 2. pp 5-38.

8. Janicak PG, O’Reardon JP, Sampson SM; Husain MM, Lisanby SH, Rado JT, Heart KL, Demitrack MA.  Transcranial Magnetic Stimulation in the Treatment of Major Depressive Disorder:  A Comprehensive Summary of Safety Experience from Acute Extended Exposure, and During Reintroduction Treatment.  J Clin Psychiatry.  2008;69:222-232.

9.  Richelson E. Mechanisms of Action of Repetitive Transcranial Magnetic Stimulation and Vagus Nerve Stimulation.  Psychiatric Annals.  2007: 36(3), 181-187.

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