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By Dr. David Woo - August 18, 2022
Welcome to Madison Avenue TMS & Psychiatry’s Mental health in the News weekly update. Below are some current news events relating to mental health and mental health treatments.
A New Study Shows that Repetitive Transcranial Magnetic Stimulation (rTMS) Reduces Suicidal Thoughts in Mental Health Patients
People suffering from depression often report having suicidal thoughts and 700,000 peopledie from suicide each year. Currently, depression can be treated with talk therapy, psychotropic medication, and electroconvulsive therapy (ECT). However, due to the complex risk factors of suicide, it is unclear how effective these treatments are. Therefore it is important to develop new strategies, like repetitive transcranial magnetic stimulation (rTMS) to prevent suicidal behavior and tendencies in patients with mental illnesses. rTMS is a non-invasive procedure that uses magnetic fields to stimulate the brain and has been shown to ease symptoms of depression.
Guan-Wei Chen and his team recently conducted a systematic review of rTMS studies to answer the following question: How effective is rTMS in reducing suicidal thoughts and behaviors?
To complete this review, Chen and his team compiled 10 eligible controlled trials from electronic databases. There were 802 participants across all 10 trials–415 patients were actively receiving rTMS treatment while 387 were in the control group receiving “sham” or placebo treatment. The main objective was to determine whether patients reported having fewer suicidal thoughts from the time they started rTMS to the time they ended their treatment. The second objective was to determine if patients’ depression severity decreased.
The study concluded that:
- rTMS does reduce suicidal thoughts and the severity of depression in people suffering from mental illnesses
- rTMS reduced suicidal thoughts in patients with non-treatment-resistant depression (non-TRD) but not in those suffering from treatment-resistant depression (TRD)
- Participants who had more than 10 rTMS sessions had better outcomes than those who had less
- Patients that received rTMS in conjunction with other treatments, like antidepressants, had better outcomes
- rTMS patients tolerated the treatment without severe side effects
While this study was limited in the number of participants, and more research is needed before generalizing the outcomes, the results suggest that rTMS is a safe, effective, and promising treatment to reduce suicidal behaviors in patients with major mental health disorders.
To read the original news article, click here.
Repetitive Transcranial Magnetic Stimulation (rTMS) May Reduce Cannabis Use Disorder (CUD) in Patients with Schizophrenia
A new study by the Center of Addiction and Mental Health (CAMH) suggests that repetitive transcranial magnetic stimulation (rTMS) may help people with schizophrenia who abuse cannabis.
Worldwide, there are 21 million people suffering from schizophrenia, a severe mental disorder that causes hallucinations, delusions, disorganized thinking, and a host of other disabling symptoms. Cannabis use disorder (CUD) is very high in people with schizophrenia (25%) compared with the general population (3%). There is strong evidence that CUD exacerbates schizophrenic symptoms and decreases quality of life. Currently, there is no approved treatment for CUD in patients with or without schizophrenia.
Researchers are now exploring rTMS (repetitive transcranial magnetic stimulation) as a treatment for CUD and other substance abuse disorders. rTMS is a non-invasive FDA approved treatment that uses repeated magnetic pulses to stimulate the brain. rTMS is normally used to treat people with depression who don’t see an improvement in their symptoms from traditional treatments like talk therapy and medication, but it is recently being researched for other disorders, such as drug addiction.
In a unique double-blind study conducted by CAMH, 19 outpatient patients with CUD and schizophrenia volunteered to participate. Half of the participants were randomly selected to receive rTMS treatments, while the other half received sham rTMS treatments. The participants came into the center to receive their treatments five times a week for four weeks. The stimulation focused on the dorsolateral prefrontal cortex (DLPFC): the part of the brain that is associated with executive functions, like decision making and impulse control. In participants receiving rTMS, cannabis use was reduced by 60% versus those who received sham treatments. Participants also reported a reduction of cravings and an improved ability to pay attention and focus.
More research is needed to determine how effective rTMS is in reducing CUD. However, CAMH doctors are hopeful that this study will pave the way for future studies.
To read the original news article, click here.
Getting TMS: What It’s Really Like. Insights from a TMS Patient.
Jamie Elmer is a copy editor, writer, and dog lover. She also suffers from treatment resistant depression (TRD) and finding relief for her symptoms has been a difficult journey. So when her doctor suggested transcranial magnetic stimulation (TMS), she decided to give it a shot.
In an essay for PsychCentral, Ms. Elmer details the entire process of getting TMS treatments in 2017, from her psychiatrist prescribing it to her, to figuring out costs and insurance coverage, to her first appointment, and finally, the results of the treatment.
At her intake appointment, the technician started by taking measurements of her head so that the TMS coil would fit her properly. When she first started, the coil was like a helmet, but by the end of her treament, the clinic had a new machine and the coil resembled a showercap. After placing the coil on her head, the technicians tested her motor threshold by testing how much power was needed to make her thumb twitch. According to Ms. Elmer, the TMS feels like being strongly tapped on the head over and over again.
After the first session, Ms. Elmer experienced some dizziness and had to drink some water, but aside from a couple of headaches, she experienced no other side effects during her treatment. The most common side effects of TMS are mild and include headaches, dizziness, discomfort or tingling in the scalp.
Ms. Elmer says she got used to the tapping sensation and went for five days a week for twenty minute sessions for four weeks. She continued the treatment after the four weeks, but reduced her sessions to three, then two, and then one session per week before finally stopping.
While Ms. Elmer shares, with honesty, that TMS did not significantly reduce her depression symptoms, she says others have had success and she encourages people to try it. She says, “If I had the chance, I’d try it again because I will never stop trying to improve my symptoms and manage this condition.”
To read the original news article, click here.
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