Transcranial Magnetic Stimulation (TMS) Depression Treatment

IMPORTANT: TMS therapy is not included nor is it a part of the treatment program at Malibu Horizon. The TMS treatment is optional and billed separately. TMS is done at an off-site location and not at Malibu Horizon.

TMS is an effective therapy for:

• Depression
• Anxiety
• OCD - Addiction
• Chronic Pain
• Bi-Polar

TMS is a new, non-invasive treatment for depression. Some people suffering with depression do not respond to prescribed medications. And the long term side effects of taking anti-depressants can cause serious complications. TMS Therapy has been demonstrated to be a very effective new treatment for depression and other issues.

TMS Therapy is a treatment that can be performed in a psychiatrist's office, under their supervision, using a medical device called the NeuroStar, TMS Therapy system. TMS is designed to stimulate the prefrontal cortex portion of the brain. The prefrontal cortex regulates a person's mood. It also controls a person's limbic system where the desire for pleasures, such as food, sex, alcohol and drug use, is located.

What exactly is TMS?

TMS stands for transcranial magnetic stimulation. It is a noninvasive method of exciting the neurons in the brain. Weak electric currents are induced in the tissue by rapidly changing magnetic fields. This way, brain activity can be triggered with minimal discomfort. It is a treatment tool for various psychiatric conditions including major depression, anxiety and addiction.

NeuroStar TMS Therapy is an appropriate treatment option 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.

FDA Approved

NeuroStar TMS Therapy is a new treatment cleared by the US Food and Drug Administration (FDA) for patients suffering from depression* who have not achieved satisfactory improvement from prior antidepressant treatment.

Benefits of Transcranial Magnetic Stimulation

NeuroStar TMS Therapy is:

• Non-invasive, meaning that it does not involve surgery. It does not require any anesthesia or sedation, as the patient remains awake and alert during the treatment.
• Non-systemic, meaning that it is not taken by mouth and does not circulate in the blood stream throughout the body.

The typical initial treatment course consists of 5 treatments per week over a 4-6 week period, for an average of 20-30 total treatments. Each treatment session lasts approximately 40 minutes.

*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.

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How Does NeuroStar TMS Therapy Work?

Through a treatment coil, the NeuroStar TMS Therapy system generates highly concentrated, magnetic fields which turn on and off very rapidly. These magnetic fields are the same type and strength as those produced by a magnetic resonance imaging (MRI) machine.

The treatment coil is applied to the head above the left prefrontal cortex. This part of the brain is involved with mood regulation, and therefore is the location where the magnetic fields are focused. These magnetic fields do not directly affect the whole brain; they only reach about 2-3 centimeters into the brain directly beneath the treatment coil. As these magnetic fields move into the brain, they produce very small electrical currents. These electrical currents activate cells within the brain which are thought to release neurotransmitters (serotonin, norepinephrine and dopamine).

In clinical trials, half of the patients had been treated with at least four medication treatment attempts, one of which was at an adequate dose and duration. Not all patients are appropriate candidates for NeuroStar TMS Therapy. To determine if NeuroStar TMS Therapy may be right for you, talk with your physician. Patients need to be considered to be resistant to prior treatment.

NeuroStar TMS Therapy has not been studied in patients who have not received prior antidepressant treatment. Efficacy 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.

*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.

NeuroStar TMS Therapy has been demonstrated to be safe and comfortable

Over 10,000 active treatments were safely performed with NeuroStar TMS Therapy during the clinical trials.

1. No side effects such as weight gain, sexual problems, stomach problems, sleepiness, or dry mouth were seen during trials
2. There were no negative effects on memory or ability to concentrate

The most commonly reported side effect related to treatment was scalp pain or discomfort during the treatment session. This side effect was generally mild to moderate, and occurred less frequently after the first week of treatment. Less than 5% of patients treated with NeuroStar TMS Therapy discontinued treatment due to side effects.

Efficacy was established in a controlled clinical trial comparing active treatment with the NeuroStar TMS Therapy system to an inactive device. Patients treated with active NeuroStar TMS Therapy experienced an average reduction in their depression symptom score of 22.1% compared to a 9% average reduction in patients receiving inactive treatment. NeuroStar-treated patients also experienced significant improvement in anxiety, appetite changes, aches and pains, and lack of energy associated with depression.

In an open label trial, which is most like a real world clinical practice, approximately 1 out of 2 patients treated with NeuroStar TMS Therapy experience significant improvement in depression symptoms; approximately 1 out of 3 patients treated with Neurostar TMS Therapy experienced complete symptom relief at the end of 6 weeks. As with any antidepressant treatment, patients should be monitored for symptoms of worsening depression.

Risks

As it induces an electrical current in the human brain, TMS and TMS can produce a seizure. The risk is very low with TMS except in patients with epilepsy and patients on medications. The risk is significantly higher, but still very low, in TMS especially when given at rates >5Hz at high intensity.

Effects of TMS which are reported in most subjects

1. Discomfort or pain from the stimulation of the scalp and associated nerves and muscles on the overlying skin.
2. Hearing the loud click made by the TMS pulse
3. TMS in the presence of EEG electrodes can result in electrode heating and, in severe cases, skin burns
4. The long-term effects of TMS remain unknown,although no effects on cognitive capacities, such as memory, have ever been reported.

NOTE: Malibu Horizon is not a medical facility. The actual TMS procedure is done in an outside facility by a licensed psychiatrist.

IMPORTANT: TMS therapy is not included nor is it a part of the treatment program at Malibu Horizon. The TMS treatment is optional and billed separately. TMS is done at an off-site location and not at Malibu Horizon.

 

read a recent article about TMS

Non Liability for Professional Services

All patients and their doctors have individual treatment agreements for services rendered. All doctors of medicine furnishings services to clients at Malibu Horizon are independent consultants, not employees or agents.