How have tech advances brought about better depression treatment for patients?

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Technology is Here to Help with Treating Depression

Source: Photo by Alex Knight on Unsplash

Technological advancement in healthcare has created a paradigm shift in the way that depression is treated. The former methods of treating and managing symptoms of depression are still used, with varying degrees of risk and effectiveness. Medications for example are not without side effects. Selective Serotonin Reuptake Inhibitors (SSRIs) and Seretonin and Norepinephrine Reuptake Inhibitors (SNRIs) are two of the most commonly prescribed categories of meds for treating MDD (Major Depressive Disorder). 

The most commonly reported side effects of SNRIs and SSRIs include fatigue, nausea, dry mouth, dizziness, constipation, sexual dysfunction, appetite loss, excessive sweating, and headaches. Sometimes, antidepressant medication can lead to an increase in suicidal thoughts. Medications can also interact with one another, often with adverse effects. When patients suffering from MDD are not showing signs of improvement from their meds, alternative treatment options are needed. TMS (Transcranial Magnetic Stimulation) is one such technologically-advanced option now available for treating Major Depressive Disorder. 

So, how does it work?

The Technology Behind TMS

Transcranial Magnetic Stimulation or TMS for short, is a non-invasive, FDA-approved treatment for MDD. It brings sophisticated technology to the fore, in the form of a specialized helmet that emits magnetic pulses. These are targeted at specific areas of the brain, to stimulate nerve cells. By doing so, TMS improves the mental health and wellness of the patient by combating the ‘depression-elements’ through neural activity. TMS is a non-invasive procedure. That means it does not require surgical incisions, anesthesia, post-operative care, and there is no risk of infection. It is conducted while the patient is fully awake, with no sedatives required. The use of repetitive magnetic pulses with TMS is known as rTMS. TMS is FDA-cleared for MDD and migraines. Deep TMS is FDA cleared for the treatment of MDD, anxious depression, OCD, and smoking addiction. 

The TMS helmet is the primary device used to house the powerful technology behind this treatment regimen. The electromagnetic coil is placed on the scalp, near the area of the brain being targeted with magnetic pulses. Repetitive pulses are used to stimulate those areas of the brain thought to be responsible for depression. These nerve cells control mood, and are thought to be significant influencers on depression. The exact manner in which the stimulation works is not known with 100% certainty, suffice it to say that TMS works. Symptoms of depression are certainly eased with TMS treatment over time. 

Depending on the treatment center, a standard TMS session can last anywhere from 20 minutes to 40 minutes, with patients usually undergoing several weeks’ worth of treatment. It is important to point out that TMS does not always supplant traditional treatment options such as antidepressants, mood stabilizers, psychotherapy, and the like. TMS is often used synergistically to achieve the desired results. This particular technology is recommended when medication and therapy don’t work. Put differently, it is among a few treatment options perceived as the last line of defense for treating depression. The others are surgical options, and they have much higher attendant risks. The likes of Deep Brain Stimulation (DBS), Vagal Nerve Stimulation (VNS), and Electroconvulsive Therapy (ECT) are highly effective, but also risky.

What are the Risks of Using New Technology like TMS?

Broadly speaking, TMS is a safe technology to use. A study published in Clinical Neurophysiology found that both transcranial magnetic stimulation and deep transcranial magnetic simulation were well tolerated, and generated the same safety outcomes as sham groups. Put differently, they were safe. There are no long-lasting side-effects with TMS, and the only potential side effects include things like ringing in the ears (if protective ear plugs or headphones are not used), headaches, dizziness, site discomfort, or jaw pain. With TMS for depression, TMS pain at the site of treatment and discomfort at the site of treatment accounted for 44% of the most commonly reported side effects.

Not everybody is a suitable candidate for TMS. Since this utilizes electromagnetic pulses, there are certain exclusions. For example, patients with a history of migraines, seizures, epilepsy, metal plates in their head, neck, shoulders, pacemakers, dialysis patients, pregnant or nursing patients, or patients with psychotic symptoms, et al are invariably unsuitable candidates for deep transcranial magnetic stimulation. In fact, any patient who doesn’t meet the DSM criteria for a specific mental health condition such as MDD should not undergo deep TMS. Age-related constraints are also in place, so nobody outside of the bracket 18 – 68 should be treated with TMS.