TMS Predictors of Outcome

TMS Predictors of Outcome in Bipolar Depression and Unipolar Major Depression

Peter Forster Bipolar Treatment, Major Depression, Treatments of Depression Leave a Comment

What TMS predictors of outcome in bipolar depression and unipolar major depression can we use to identify those who are likely to respond to treatment? An article in 2017 in the journal Clinical Neurophysiology reports data from a very large series of patients with both types of depression who were treated with TMS. The study looked at records from 105 …

Maintenance TMS

Maintenance TMS

Peter Forster Major Depression, Treatments of Depression Leave a Comment

A patient with treatment resistant depression and an excellent initial response to TMS asked me about the value of maintenance TMS. The question is a reasonable one given what we know generally about the treatment of chronic and/or treatment resistant depression. Almost all of the effective treatments (psychotherapy, medications, ECT, etcetera) have acute and maintenance treatment components. And for all …

TMS Effectiveness Updated

Peter Forster Best Practices, Major Depression, Treatments of Depression

TMS effectiveness for depression is clear. But now there are more machines for providing TMS and more protocols. Is deep TMS better than regular TMS?  Or is deep TMS just a marketing phrase? A major review article in JAMA Psychiatry updated our understanding of alternatives to the initial protocol for TMS. JAMA Psychiatry is the most prestigious journal in psychiatry, …

TMS for Anxiety

Peter Forster Anxiety

“How effective is TMS for anxiety?” The young woman with a remarkable history of serious adverse effects from multiple trials of psychiatric medications for anxiety recently asked me this question. This post summarizes the results of a thoughtful literature search using the UCSF medical library, data from the Medical Affairs departments for two of the TMS manufacturers, and clinical experience at …

TMS for Depression – Repeat Treatment

Peter Forster Treatments of Depression

TMS is an expensive, time-consuming, but effective treatment for depression, but how should it be used for treating patients with chronic depression? And for those who have an initial positive response when should we consider another course of TMS (known as reintroduction therapy)? These are all questions which have not been adequately addressed in the research literature. A study published in …

TMS Guidelines

Peter Forster Treatments of Depression

In the April edition of Brain Stimulation, the Clinical TMS Society published expert consensus guidelines on the use of TMS. This definitive review of the literature identifies both what is known as well as significant areas of uncertainty about the use of TMS in the treatment of depression. The process of developing the guideline is described in the introduction to the …

TMS Stimulates Brain Growth

Peter Forster Psychobiology, Treatments of Depression

In a recent poster presented at the 2015 Society of Biological Psychiatry meeting Martin Lan and colleagues presented data from the first study of structural changes in the brain following TMS. In the study, 27 patients in an episode of major depression underwent MRIs before and after receiving TMS treatment. Several cortical regions related to cognitive appraisal, the subjective experience of …

TMS Cost Effectiveness

Peter Forster Costs of Treatment, Treatments of Depression

“Is TMS Cost-Effective?” His provocative title of an article just published in psychiatric times which summarizes an Australian pharmaco-economic study. In case you don’t want to read through the rest of this article, here is the summary: “Australian researchers compared the cost-effectiveness of rTMS with pharmacotherapy in treatment-resistant patients with MDD (ie, those who have failed at least 2 courses …

TMS Updates May 2015

Peter Forster Treatments of Depression

The editors of Bipolar News reported on some interesting presentations related to transcranial magnetic stimulation (TMS) at the Biological Psychiatry meetings this past May. TMS for geriatric depression – “Researcher Daniel Blumberger reported that he has found repeated transcranial magnetic stimulation (rTMS) to be effective for depression in late life. Blumberger noted thatit may be necessary to use higher intensity …