Novel treatments for depression – are they for real?
Recently on a social media group someone asked if TMS (Transcranial Magnetic Stimulation) really was a treatment for depression or just another “alternative therapy hoax”. Here’s some information to update you on TMS:
- TMS is a non-invasive electromagnetic brain stimulation technique that is well tolerated and has only mild, transient side effects during sessions. It is delivered in a series of 20 to 30 twenty-minute sessions, delivered on weekdays and tailing off in frequency after the acute course.
- A large body of research conducted worldwide (including at Black Dog Institute) indicates that TMS has antidepressant effects when applied over the frontal, cortical areas of the brain. It is now an approved treatment for depression in Australia by the Royal Australian and New Zealand College of Psychiatrists and has also been approved in Canada, the European Union, Israel, New Zealand and the USA.
The Sydney Neurostimulation Centre (SyNC) is a research, clinical assessment and treatment centre based at the Black Dog Institute. It is led by internationally respected psychiatrist and researcher, Professor Colleen Loo, who conducted the first clinical trial of Transcranial Magnetic Stimulation (TMS) in Australia starting in 1997. On the basis of the research findings The TMS Clinic at Black Dog Institute was opened by the Governor of NSW, His Excellency General The Honourable David Hurley, in December 2014. The Clinic offers TMS as an outpatient treatment for depression and other psychiatric disorders. Referrals are accepted from GPs and psychiatrists for an assessment of patients regarding suitability for TMS. Professor Loo’s team are also training other Australian psychiatrists to deliver TMS, which promises to be a breakthrough treatment for some people whose depression has not responded to pharmacological interventions.
You can read more about TMS in these Scientific American articles; this one from 2010 and this one from 2015 . Another article from 2016 describes the author’s experience of TMS for treatment of anxiety.
Also in the category of “novel” treatments are Transcranial Direct Current Stimulation and, somewhat controversially, Ketamine. SyNC is at the forefront in investigating these novel treatments for depression, conducting the first randomised clinical trials in Australia of tDCS starting in 2007 and ketamine in 2016.
You can find out more about these novel treatments by listening to the podcast of our expert insights meeting which can be found on the expert insights podcast page (scroll down to it but beware, you might find some other podcasts that interest you along the way!)
Further reading:
J Clin Psychiatry. 2014 May;75(5):477-89; quiz 489. doi: 10.4088/JCP.13r08815.
Repetitive transcranial magnetic stimulation for treatment-resistant depression: a systematic review and meta-analysis. Gaynes BN1, Lloyd SW, Lux L, Gartlehner G, Hansen RA, Brode S, Jonas DE, Swinson Evans T, Viswanathan M, Lohr KN.
J Clin Psychiatry. 2010 Jul;71(7):873-84. doi: 10.4088/JCP.08m04872gre. Epub 2010 Mar 9.
Should we expand the toolbox of psychiatric treatment methods to include Repetitive Transcranial Magnetic Stimulation (rTMS)? A meta-analysis of the efficacy of rTMS in psychiatric disorders. Slotema CW1, Blom JD, Hoek HW, Sommer IE.
About the Authors:
Dr Angelo Alonzo PhD is Research Officer who co-ordinates research at the Sydney Neurostimulation Centre
Dr Jan Orman is General Practice Services Consultant at Black Dog Institute
Gerhard is a full professor of Clinical Psychology at Linköping University, Sweden since 2003, an
d affiliated researcher at the Karolinska Institute, Sweden. Professor Andersson is an internationally recognized researcher in the field of CBT delivered through information and communication technology, as well as the author of the book “The Internet and CBT: a clinical guide”.
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