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Magnetic Brain Stimulation May Trump Drugs For Severe Depression | Popular Science


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I love the concept of magnets as medicine:

Drugs are the most common psychiatric treatment for depression. But about 40 percent of people fail to respond to this first-line of antidepressants. What to do? The answer to date has often been more and different drugs. 

But transcranial magnetic stimulation (TMS), a technique that can revive activity in neurons in the brain's prefrontal cortex using an electromagnet, has been receiving more attention as a possible treatment for these stubborn cases of depression. In 2008, the FDA approved TMS for this purpose. Data since that point has been promising, but questions remain: How does it compare to antidepressant drugs? Is it cost-effective? 

Research presented today (May 6) at the American Psychiatric Association's annual meeting in New York suggests that the technique is perhaps better than previously thought. In the study, the researchers compared two groups: those who had received TMS after failing to respond to drugs, and those who were given new antidepressants after not getting better on prior meds. The finding: 53 percent of those receiving TMS had no or mild depression after six weeks of treatment, compared with 38 percent taking a new or augmented type of antidepressant. 

The study also looked at the economics. It found that TMS therapy would cost about $10,000 per patient per year, which is considered quite affordable.

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In TMS therapy, an electromagnet is applied to the left side of the forehead. This induces currents in neurons in the left prefrontal cortex--where brain imaging studies have shown a deficit in activity in depressed patients. It is thought that this can induce activity and blood flow to this area, but also causes changes in areas deeper in the brain (responsible for mood regulation) to which neurons in the cortex connect. Side effects of TMS tend to be mild, especially compared to antidepressants, and the most common complaint is a mild headache, Simpson said.

Exactly how TMS works is a mystery, Dr. Janicak said. But the same can be said of antidepressants, he added. 

Wait, no one knows how antidepressants work???

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