Mental Health in the News: October 6, 2022

By Dr. David Woo - October 6, 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.

TMS Can Help Older Patients–They Just Need a Little More Time

A new study conducted by the Hinda and Arthur Marcus Institute for Aging Research and the Deanna and Sidney Wolk Center for Memory Health at Hebrew SeniorLife suggests that the commonly held belief that transcranial magnetic stimulation (TMS) is not an effective treatment for older adults is in fact not true. Instead, researchers suggest that TMS is as effective in older adults as in younger ones–they just need a little more time.  

Many patients 65 and older suffer from depression. While there are a variety of treatments available for depression, like medication and psychotherapy, many older patients are resistant (do not find relief or enough relief from treatment) to these first-wave treatments. When this occurs, it’s referred to as treatment resistance.

Furthermore, treating depression in older adults is often complicated by what is known as comorbidity and polypharmacy. Comorbidity means that a patient has been diagnosed with more than one chronic condition. For example, if someone has been diagnosed with PTSD and depression, they are said to have comorbid PTSD and depression. Polypharmacy is the term used when a patient is taking more than one medication. 

For this reason, doctors and patients look to treatments other than medication, like TMS. TMS is a non-invasive and FDA-approved procedure for depression that stimulates the brain using magnetic fields and has shown positive results in treating depression. 

While earlier studies claimed that TMS was not effective for older patients with depression, the new study suggests that TMS has the same efficacy in older adults as younger ones. The difference is that younger adults usually respond to treatment after four weeks, while older adults need six weeks. Dr. Alvaro Pascual-Leone, the lead author of the study, says that this finding has direct implications for healthcare policy as “many major insurance providers in the U.S. have coverage policies that hinge on a clinical response within four weeks. They need to expand coverage to at least beyond six weeks of treatment to ensure maximal benefit for older adults who are in particular need of effective treatment options for major depression.” 

To read the original news article, click here.

How Does Transcranial Magnetic Stimulation (TMS) Work?

Transcranial magnetic stimulation (TMS) is a non-invasive treatment that uses magnetic pulses to treat depression and other mental health disorders. TMS is FDA approved for the treatment of depression, anxious depression, and obsessive-compulsive disorder and is not associated with the systemic side effects antidepressants are known to cause. TMS is often recommended for patients who are treatment resistant–meaning that they do not respond (or do not find enough relief from their symptoms) to first-wave treatments, like antidepressants. So, how does TMS work?

TMS works by sending magnetic pulses to the brain and eliciting an electrical response in the brain’s cells. A stimulator is used to create a current that is sent through the coil and creates a magnetic field that goes through the skull and into the brain. In this way, the patient’s brain is altered. 

During the first session, a doctor or technician will adjust the coil over a person’s head to make sure it fits. Next, they will determine the appropriate intensity by slowly increasing the level of pulses until there is an involuntary twitch in the patient’s finger. This twitching is not painful or dangerous. 

Once treatments start the patient can expect to feel a strong tapping on the head or tingling sensation that stops once the machine is turned off. One common side effect patients can experience are headaches. 

Before starting TMS, it’s important to talk to your doctor to see whether TMS is right for you.

To read the original news article, click here.

Dr. David Woo

Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.