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TMS Offers More Hope To Patients with Depression

Monday, September 27th, 2010

New treatment offers more hope
Hartford, Conn. (WTNH) – Martha Rhodes has lived with depression since she was a teenager. Anti-drepressants and therapy were her prescribed treatment.
“It’s a dark feeling,” Rhodes said. “It’s when you wake up every morning and you think I wish I wasn’t here. It’s where you don’t care about your life.”
Despite a loving husband, two children and in otherwise good health, Martha still could not connect the dots day to day.

“I was cautious but I was also down to no more cards,” Rhodes said. “I was desperate.”
Desperation brought her to the Institute of Living at Hartford Hospital. The first to offer in Connecticut, Transcranial Magnetic Stimulation, recently approved by the Food and Drug Administration.
“It’s the first major new treatment for depression in decades,” psychiatrist John Goethe said. “The magnet goes on and off, very, very rapidly.”
TMS sends magnetic pulses to the brain, stimulating nerve cells in the area linked to depression.
“When you pass a magnetic current in a certain way over living tissue, it creates an electrical current and you locate it in a precise position, you can stimulate an electrical current in a particular brain circuit,” Dr. Goethe said
Patients undergo daily stimulations across four to six weeks.
“You feel a very intense tapping on this part of your scalp,” Rhodes said. “You get used to it. It’s intense but you do get used to it. The trick to this whole thing is trusting that you are going to be better.”
Signs of improvement were slow but steady.
“I noticed that the music I was listening to was more upbeat,” Rhodes said. “I noticed that I started singing to the music. Some people prefer this to medication. Some people would come to TMS even if they hadn’t had a long history of depression. Life is easy now, its not the struggle that it was and believe me, when you have depression its like climbing a mountain every day of your life.”
Dr. Goethe says the majority of patients do respond, but not all will have a full recovery.

published by www.southshoretms.com

Tags: depression, major depression, psychiatry, therapy, transcranial magnetic stimulation
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TMS Reported in Psychiatric Times

Tuesday, September 21st, 2010

https://www.cmellc.com/landing/pdf/A10001091.pdf

Psychiatric Times reports on TMS Therapy becoming Category 1 insurance code. This article reviews the benefits of TMS Therapy for those not acheiving satisfactory results from their current medication regimen.

provided to you by www.southshoretms.com

Tags: depression, major depression, psychiatry, tms, transcranial magnetic stimulation
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THE FUTURE OF MENTAL WELLNESS

Wednesday, September 8th, 2010

The alarm shrills in the morning signaling you to get up. You hit the snooze button and hope that this may be the day you’re able to find some purpose, joy, or maybe a little excitement about anything. Anything besides that familiar feeling of numbed, inexplicable sadness.
As you lie there, you realize that this day is going to be like so many others before it.
You drag yourself out of bed and go through the motions, seeing people and places in a kind of
gray, dreamlike state while berating yourself for feeling the way you do. Family members and
friends are concerned. Some are kind, some tell you that there are others far worse off than
you, and still others tell you to snap out of it. You wish you could, but you don’t have the desire
or strength to feel any other way.
You have strange aches and pains. Headaches. Backaches. Joint pain. You’re moody,
anxious, worried, and angry. Your physician can’t find anything wrong with you. You describe
your symptoms and she/he prescribes an antidepressant.
You try one, then another. In the meantime, you may suffer through a period of
increased or decreased appetite, insomnia/drowsiness, increased anxiety or lack of sexual
desire or function. Some of these effects may go away, others may not. You learn about
neurotransmitters and chemicals of the brain; serotonin, dopamine and how certain medication
affect these. But what is wrong with yours?
Depression and the Complexities of the Human Brain
Depression. It manifests itself in a number of ways. Some of the greatest artists,
writers, physicians and everyone in between has suffered and suffers from depression. The
1950s brought Monoamine oxidase inhibitors (MAOIs) and Tricyclic Antidepressants (TCAs) that
relieved some sufferers, but posed numerous and dangerous side effects.
In the late 80s, the Mac Daddy of antidepressants, Prozac, was released and millions
benefitted from it. Prozac was the wonder drug; a Selective Serotonin Reuptake Inhibitor
(SSRI) and the grandfather of the ones that came after; Zoloft, Paxil, and Effexor, to name a
few.
SSRIs increase serotonin, a chemical in the brain that affects mood. Studies suggest
those suffering from depression have a chemical imbalance whereby serotonin stops between
the synapse, the gap between nerve cells in the brain. Simply put, antidepressants are
purported to stop receptors from “turning off” serotonin.
Antidepressants do not hone in on a specific area of the brain. They alter the entire
biology of a person, including the nervous system which uses those same transmitters. The
result is those less than desirable side effects.
Our brains are what makes us who we are; our own unique selves. Our behavior,
moods, feelings and a myriad of functions and emotions are tied into the sophisticated
magnificence of this amazing organ‐‐it runs the show.
A seven‐year study, the Sequenced Treatment Alternatives to Relieve Depression
(STAR*D), conducted by the National Institute of Mental Health concluded that when
medication was used for depression a third of patients got better; a third received some
benefits, and others received no benefits at all.
For those two‐thirds of patients that continue to suffer from depression, the statistics
seem bleak.
The Future for Treating Depression
In 2008, the FDA approved Transcranial Magnetic Stimulation (TMS) to treat adults with
major depression. NeuroStar TMS Therapy® is a system whereby patients sit in a comfortable
chair (much like a dental chair) and a magnetic coil is placed against one side of the scalp. Using
focused magnetic impulses to the left prefrontal cortex (area of the brain believed to regulate
mood), this outpatient procedure takes approximately 30 minutes and is similar to an MRI scan.
During the procedure, the patient is monitored continuously to ensure correct position
and comfort level. Some patients watch television; others talk to the clinician and others opt to
drift to a state of total relaxation. The patient and clinician are in control and the procedure,
painless and non‐invasive, is free from the adverse systemic side effects associated with
antidepressants. The patient can resume regular activities immediately after each session.
Through followup sessions each week for three to six weeks, patients have reported
significant improvement in depression symptoms. In clinical trials, one out of three
experienced complete symptom relief at the end of a six‐week period.
The Experts
Dr. Edward Fruitman, a nationally‐recognized expert in the field of Psychopharmacology,
is the first psychiatrist to use TMS therapy in the Five Towns area of Long Island and is among
an elite few in Long Island that uses this procedure as part of his methodology. Dr. Fruitman’s
approach to mental health is treating the whole person as a unique individual.
“We cannot treat all patients with one neurobiological set of rules. What we know now
through the study of human behavior, nutrition neurotechnology, holistic treatment and the
complexities of the human brain is that we must focus on the whole person and gear our
treatment toward his or her’s unique psychological and physiological makeup. TMS is not only
the future for treating depression, but may also be very beneficial toward treating other
neurological disorders such as Parkinson’s, Alzheimer, and migraines.”
The Lecture
Dr. Fruitman’s lecture will focus on the benefits of using TMS therapy and mental
wellness. He has conducted hundreds of sessions using TMS therapy. You’ll learn not only
about the latest treatments, procedures and medications to treat depression, but holistic
methods you can start using immediately. You’ll receive a free copy of his publication, “Healing
the Mind‐‐Ten Steps you Can Take to Improve Your Mental Wellness and Mood.” The lecture
also includes an intensive question and answer session.
Learn what you need to do in order to improve your life. Take the next step toward
relieving your depression, once and for all. Schedule a free consultation with Dr. Fruitman and
his staff to find out what your therapy should be in order to live the life you deserve‐‐fully, and
with limitless possibilities.
………………………………………………………………………………………………………………………………………
..
Dr. Edward Fruitman is a Diplomat of the American Board of Psychiatry and Neurology. He has
a Bachelor of Science in Biology and a Bachelor of Arts in Psychology from the University of
Michigan, and received his Doctor of Medicine (MD) from Michigan State University, College of
Medicine. Dr. Fruitman is a nationally‐recognized speaker with over 700 lectures and
presentations to his credit at medical conferences and educational settings. He has served as
Medical Director for a large non‐profit agency with outpatient psychiatric treatment centers in
New York for 15 years and treats private patients by appointment at his private practice, South
Shore Neuropsychiatric Center, in Hewlett, New York.
To learn more, visit http://www.southshoretms.com/ or call 516‐295‐4867

By Brigitte Surette

Tags: major depression, psychiatry, tms, transcranial magnetic stimulation
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Medical Breakthroughs in Hudson Valley, NY

Tuesday, August 24th, 2010

Using magnets to fight the blues
Severe depression cripples the lives of nearly 15 million Americans every year, according to the National Institute of Mental Health. Psychiatrist Randy Pardell, M.D. uses a new technique that he says shows great promise for many patients who suffer from major, treatment-resistant depression.

Transcranial magnetic stimulation, or TMS, uses magnetic fields to stimulate nerve cells in a region of the brain associated with mood regulation and depression. “It’s kind of like a spark plug for the brain,” explains Pardell, who heads the Poughkeepsie-based TMS Center of the Hudson Valley.

Here’s how it works: The magnetic pulses trigger gentle electrical currents in the brain, which stimulate nerve cells in the prefrontal cortex. The nerve cells release chemicals known as neurotransmitters, which affect mood and emotion.

One reason why TMS is an exciting option is because it does double duty, Pardell says: It often improves mental functioning, as well as motivation and energy, in the patient. At the same time, the procedure also appears to calm the anxiety centers of the brain, which are often overactive in people who are depressed. “Also, it’s a noninvasive, nonsystemic technique. When a patient takes a pill, it goes through the entire body. But here, the magnetic pulses are going directly to the area being treated.”

At first glance, a TMS session looks a bit like science fiction. The patient sits in what looks like a dentist’s chair; a small piece of equipment containing an electromagnetic coil is placed near the left side of the forehead. The coil emits pulses of highly concentrated magnetic fields through the skull, about three centimeters down into the brain — in a manner similar to the way an MRI unit works. “In fact, it’s the same level of magnetic intensity as an MRI — which has been used for years with very few negative consequences,” Pardell says. The patient feels a sort of tapping on the head as the magnets pulse. Afterwards, he or she can continue with normal daily activities. Side effects are mild, Pardell says: a few patients experience a mild headache or lightheadedness.

A standard TMS course involves approximately 20 sessions — five days a week for a month. “Each session takes about 37 minutes, during which about 3,000 to 4,000 pulses are given each time,” according to Pardell. The procedure has been government-approved since 2008. “The FDA approved it for use with resistant depression in adults who have tried antidepressant medication for at least a month with no improvement, or for people who have intolerance to antidepressant medication,” Pardell says.

About 200 sites across the nation now use TMS, says Pardell, who has so far treated half a dozen patients in the six months since he first brought the technique to the Valley. A course of treatment costs about $8,000-$10,000; insurance companies consider coverage for it on a case-by-case basis.

TMS is being tested, too, for its effectiveness in treating other conditions including bipolar disorder, schizophrenia, and posttraumatic stress disorder. It’s also being tested in patients suffering from Parkinson’s disease, migraines, and chronic pain.

“Many times, patients who come to us have been on 15 to 20 different medication trials,” Pardell says. “They’ve been in hospitals, sometimes had electroconvulsive [also known as shock] therapy — they’re looking for some other way to help their depression.”

Pardell cautions that TMS shouldn’t be considered a “magic bullet” therapy that eliminates depression on its own. But so far, the numbers look good. “I’ve talked to a lot of psychiatrists across the country who are doing this treatment, and the success rate seems to be somewhere between 65 and 90 percent,” Pardell says. And according to the Mayo Clinic, in cases where TMS is effective, symptoms of depression may improve for days or weeks, or may even subside completely.

“People can continue with their antidepressant medication, if needed, while undergoing TMS,” says Pardell. “And psychotherapy, along with TMS, can give many people their best chance to get well. TMS has been a wonderful adjunct to our practice.”

Randy Pardell, M.D.
Riverview Psychiatric Medicine, 845-471-1807

Tags: depression, long island, major depression, new york, psychiatry, tms, transcranial magnetic stimulation
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