TMS Updates May 2015

Peter Forster Treatments of Depression

TMS Updates May 2015The 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 stimulation (i.e. at 120% of motor threshold instead of the usual 110% of motor threshold) in the elderly in order to overcome the gap between the skull and the brain, which can grow with age due to brain atrophy.”

TMS after successful ECT“Blumberger has also successfully used rTMS as a followup treatment to a successful course of electroconvulsive therapy (ECT), administering rTMS twice a week for up to 66 treatments in a given patient in order to maintain remission of their depression.”

Glutamate levels normalize with TMS“Frank MacMaster discussed his study of repeated transcranial magnetic stimulation (rTMS) in 50 children with depression… Using magnetic resonance spectroscopy (MRS) technology, MacMaster found that children who responded well to rTMS treatment had low levels of the neurotransmitter glutamate at the beginning of the study, but their glutamate levels increased as their depression improved. Children who didn’t improve had higher glutamate levels at the beginning of the study, and these fell during the rTMS treatment.”

TMS less available in US than Canada – Sadly access to TMS in this country lags behind other countries. “In contrast, Daskalakis and his Canadian colleagues can and do use rTMS to treat a broader range of illnesses including bipolar disorder. In Canada rTMS is used to treat unipolar depression, schizophrenia, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD), and clinicians can adjust the parameters to treat adolescents and the elderly…. The situation in the US is unfair. Because rTMS has not been approved for the treatment of bipolar disorder, Carpenter and other clinicians in the US are unable to treat bipolar depression even though a wide range of experts and published studies report that rTMS is as effective (or possibly even more so) for patients with bipolar depression than for those with unipolar depression.”