New Hope for Treatment-Resistant Depression

Depression is a real and serious health condition that affects more than 20 million Americans each year. For most people, it is usually treatable with medication, psychotherapy and lifestyle changes, but others find their symptoms continue despite treatment. At Penn, an exciting new approach to treating depression is showing promise for those people who are resistant to other therapies.

Transcranial magnetic stimulation, or TMS, involves the application of focused magnetic pulses through the scalp to the cerebral cortex of the brain.

“TMS offers hope to patients who have tried other therapies without success,” said John O’Reardon, MD, director of the TMS program at Penn. “Neuroimaging studies of patients with depression show underactivity in the fronto-limbic area of the brain. TMS is focused stimulation through magnetic impulses to the prefrontal cortex. The magnetic pulses help restore normal function in those brain circuits that maintain our moods.”

TMS treatments are administered in an outpatient setting under the supervision of a licensed MD, usually a psychiatrist. A full course of treatments can range from 15 to 30 sessions. The procedure is non-invasive so patients are awake during the treatment.

“The brain is an excellent multi-tasker,” said Dr. O’Reardon. “Patients can read or carry on a conversation during treatments, usually experiencing nothing more than some minor twitching as the pulses travel through the scalp.”

Because it is non-invasive, TMS is a safe procedure and is usually tolerated well. It lacks the side effects of many antidepressants, such as weight gain, sexual dysfunction and sleepiness. The most common side effect of the treatment is a headache, especially in patients who are prone to migraines and headaches.

Dr. O’Reardon was the principal investigator for the TMS study at Penn that led to U.S. Food and Drug Administration (FDA) approval as a treatment for depression. Treatments at Penn began in August 2008 and 20 patients have received the novel therapy. Of those, 68 percent experienced “much improvement” in their depressive symptoms.