Electromagnetic Treatment Offers Hope for Depression

Approximately 21 million U.S. adults experienced a major depressive episode in 2020, according to the National Institute of Mental Health. Worldwide, depression is the leading cause of disability. For the 20 percent of patients whose depression doesn’t improve with medication or psychotherapy, transcranial magnetic stimulation (TMS) may hold the key to feeling better.

Physicians at Miami Neuroscience Institute say they are having success with the targeted therapy and that research shows it is helping eight out of 10 patients suffering from major depressive disorder, a clinical depression that can be chronic and long-lasting.

“TMS gives hope to patients for whom medication has failed,” says Rachel Rohaidy, M.D., a neuropsychiatrist at Miami Neuroscience Institute, which is part of Baptist Health. “It’s non-invasive, requires no sedation and causes minimal side effects. Most importantly, we can deliver a personalized dose to the target area and adjust the stimulation level to optimize therapy.”

How does TMS work?

The procedure uses pulses of electromagnetic energy to target specific areas of the brain commonly associated with depression. With an MRI scan and the TMS unit’s sophisticated navigation tools, doctors are able to deliver electromagnetic energy to the precise location they target.

Patients who qualify typically receive TMS three days a week for 10 to 12 weeks. “Patients are fully awake and can return to work immediately after their appointment,” Dr. Rohaidy says. “The only side effect we see is a mild headache and scalp pain at the treatment site.”

For patients who are apprehensive about an older, but still used, treatment for major depressive disorder ― electroconvulsive therapy or ECT ― TMS may be ideal. ECT uses small electric currents to trigger brief seizures, effectively “rebooting” the brain. “ECT is safe, reliable and effective, but old misconceptions about it can scare people off,” Dr. Rohaidy explains. “Plus, it requires sedation.”

TMS is FDA-approved and some patients notice improvement in their symptoms quickly. “TMS doesn’t fix everything, but we have been very impressed with the results so far,” she says. “Many patients report a 50 percent reduction in their symptoms after just three sessions.” She adds that for the best results, patients should continue receiving psychotherapy during and after TMS treatment.

Expanding the use of TMS

The experts at Baptist Health Miami Neuroscience Institute are also working to expand the use of TMS and conduct research on additional mental health problems. “Scientists have identified 17 foundational neural networks in the brain so far, and the networks are interconnected,” says John Candela, neurological systems consultant at the Institute. “Neurons in more than one area feed into depression, and specific areas of the brain are heightened in patients with addiction, post-traumatic stress disorder, anxiety and other mental health concerns.”

He is hopeful that the technology will eventually be able to treat multiple mental health issues at once. Neurosurgeons at the Institute already use TMS and MRI to perform pre-surgical brain mapping in patients with epilepsy and brain tumors. It helps them identify areas of the brain associated with movement and speech and enables them to avoid critical structures during surgery.

TMS therapy is usually covered by insurance, although most plans require evidence that the patient has not achieved symptom relief with three different medications plus psychotherapy or has experienced severe side effects from the medications.