[By M.C. Millman]

Rockland TMS & Wellness Center at the Bikur Cholim of Rockland County in Monsey, NY has recently acquired a new FDA approved device to be used for Transcranial Magnetic Stimulation (TMS).  TMS, approved for the treatment of depression, is a new alternative that uses magnetic waves to stimulate the body to heal itself.  The patient remains fully awake during treatment.

Major depression is a serious medical illness affecting more than 14 million American adults yearly.  Depression can be a debilitating disorder that interferes with an individual’s thoughts, mood, behavior and physical health.  The economic burden of depression in 2000 was estimated at $831 billion in the United States.

While the exact cause of depression is not known, the leading scientific theory is that it is caused by an imbalance among the brain’s neurotransmitters.  Neurotransmitters are chemical messengers that send signals between brain cells.  Depression is most often treated with antidepressant medications, which seem to work by increasing neurotransmitters.

But antidepressants don’t always work.  Despite advances in treatment, four million depressed patients each year have poor responses to or are intolerant to their antidepressant medication.  Many refuse to discuss their depression with qualified health-care personnel, which meant they don’t get talk therapy either.

But now there is another option. In 2009, after more than ten years of clinical studies, the FDA approved the Neurostar TMS Therapy system, a new and highly effective option for treating major depressive disorder without the use of medication and its side effects.

TMS treats depression by using an electromagnetic field, similar to the magnetic fields used by MRI machines.  The magnetic field produces electric pulses, stimulating the brain to heal itself through neurogenesis—the creation of new neurons that grow and form new connections.  This results in changes in the brain that are beneficial in the treatment of depression.

In clinical studies, more than half of the patients treated for symptoms of depression experienced significant improvement.  About a third had complete relief of their symptoms at the end of six weeks.  TMS treated patients also experienced a significant decrease in anxiety and physical symptoms like the appetite changes, aches and pains, and lack of energy associated with depression.

The most exciting part of the treatment is the near total lack of side effects.  Unlike the case when using antidepressants, there are no systemic side effects; no weight gain, no sedation, no nausea, no dry mouth, no adverse effects on concentration or memory, no hospitalization and no anesthesia.

During the procedure the patient is fully awake and alert, so that it is often considered beneficial to use the thirty-seven minutes of the procedure to conduct a psychotherapy session or just relax.

Since TMS is administered directly to the spot on the brain requiring the pulse, the system is considered safe even for expectant or nursing mothers and can be used to treat postpartum depression.  This is an advantage over antidepressant drugs which circulate through the body and can have side effects, despite the benefits they offer once they arrive at their intended location in the brain.

(A patient with an implanted metallic device or non-removable metallic objects in or around the head is not a candidate for TMS Therapy.)

TMS Therapy uses a highly focused, pulsed magnetic field to stimulate nerve cells in the area of the brain that controls mood.  An outpatient procedure, it is performed only after an initial evaluation from qualified personnel at Bikur Cholim and takes place under their supervision. The typical treatment course consists of 5 treatments a week over four to six weeks, for a total of 20-30 treatments.  Each treatment session lasts about 37 minutes.  During those 37 minutes, there are only four seconds in every thirty second interval in which the device delivers rapid “pulses” of the magnetic field, which can feel like tapping on the scalp. The magnetic energy used in a full course of TMS Therapy is a small fraction of that in just one brain scan with an MRI.

The benefits of TMS can last anywhere from six months to two years or more.  The patient may be able to be weaned off medication or remain entirely drug free during that period and beyond.  If symptoms return, a short booster session can be initiated to bring the depression back under control.

Though not yet FDA approved for other disorders, TMS Therapy can potentially help those suffering from, post traumatic stress disorder, bipolar disorder, ADHD, migraines, stroke symptoms, and some symptoms of schizophrenia, and there is ongoing research supporting the use of TMS for the above mentioned conditions.

TMS Therapy may be covered by insurance on a case by case basis. At the current time Medicaid and Medicare do not cover TMS services. Support for getting insurance reimbursement or pre-authorization is available.

Rockland TMS and Wellness is a division of the Center for Applied Psychology (CAPs) at Bikur Cholim- a well known and much beloved licensed behavioral health center in Monsey, New York. Both programs are under the guidance of noted doctors, Dr. Isaac Schechter (Director) and Dr. Richard L. Price (Medical Director). Rockland TMS and Wellness is the product of the long-standing commitment and vision of CAPs, its parent organization Bikur Cholim-Partners in Health and CEO and Founder, Rabbi Simon Lauber, in bringing the highest level of clinical and professional care to the community.

For questions about TMS, further information or to schedule an appointment, call Rockland TMS & Wellness Center at 845-678-6070, email us at [email protected] or visit our website: www.rocklandtms.org.

(Copyright Hamodia. Reprinted with permission from Hamodia, where this article first appeared.)