Study finds TMS is an effective treatment solution for major depression

John O'Sullivan had struggled with bipolar depression since he was a teen. He has tried numerous types of psychotherapy and medication but nothing seemed to help for long.

A salesman whose profession required the constant projection of a positive, upbeat image to be successful, O'Sullivan found that his condition frequently left him feeling listless and restless. He switched jobs often and had difficulties in his family life.

"When you're in a maniacal state with bipolar, it's not like you're often happy. You're irritable and hard to live with," said O'Sullivan, a husband and father of five. "That's been tough on the family."

At age 50 and desperate, O'Sullivan was cautiously intrigued when his Loyola University Medical Center psychiatrist, Dr. Murali S. Rao, told him about a new high-tech, non-invasive therapy that uses magnetic waves to treat his condition.

"My first thought was, 'What is this?'" said O'Sullivan, a resident of Downers Grove, Ill. "But, really, I was open-minded to it because I was desperate for anything that would work quicker and more effectively."

Known as transcranial magnetic stimulation (TMS), the treatment delivers a series of electrical pulses to the part of the brain associated with depression and other mood disorders. The pulses generate an electric current in the brain that stimulates neurons to increase the release of more mood-enhancing chemicals like serotonin, dopamine and norepinephrine.

"The electrical pulses target the nerve cells in the region of the brain called the left prefrontal cortex, the region of the brain that regulates our moods," said Rao, chairman of Loyola's Department of Psychiatry and Behavioral Neuroscience Services.

A study involving 301 patients that was recently published in the journal Brain Stimulation found TMS to be "an effective, long-term treatment for major depression."

O'Sullivan's treatment took place over a span of about three weeks. It involved a series of sessions lasting about a half hour each, five days a week. He remained awake and alert throughout each session and no anesthesia or sedation was required.

"The results have been what I would call surprisingly good," O'Sullivan said. "From my experience going back to my teenage years, I've never been as optimistic about life as I am now after TMS. I feel like a million bucks. I feel great. It's a pretty big change."

There is nothing new about the use of electricity to treat depression. For years, a treatment called electroconvulsive therapy (ECT) - also known as "electric shock treatment" - has been used to induce seizures in anesthetized patients for therapeutic results.

"But since TMS uses an electrical field, not electricity like ECT, there is very little risk of a seizure from the procedure," Rao said. "The pulses are mild and painless and patients are able to immediately return to normal activities."

The short-term side effects of TMS are usually minor. Some patients experience tingling in the scalp or twitching of facial muscles. Others experience a headache, which can be relieved by any over-the-counter pain-relief medication.

"It's not all unpleasant," O'Sullivan said. "During treatment, I could feel a pulsing around my left eye but it wasn't painful."

TMS is FDA approved and is performed on an outpatient basis in a psychiatrist's office. Patients sit in a device that resembles a comfortable dentist chair. The chair reclines and has a padded headrest. It also has a touch-screen control panel and an electrical magnetic coil that is positioned on a precise spot on the patient's head.

"I've had tremendous results in the three weeks I was undergoing it," O'Sullivan said. "Medication would take six to eight weeks before I knew it was working or not. The TMS results were pretty quick and pretty dramatic."