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TRANSCRANIAL MAGNETIC STIMULATION (TMS): HOPE FOR STUBBORN DEPRESSION
As triple-digit temperatures hit the East Coast, individuals with a mental illness -- specifically those who take prescribed medication -- are at risk for heat intolerance, with psychiatric hospitalizations peaking in the summer months, according to experts.
During heat waves or especially warm days, there is often an uptick in the frequency of psychiatric hospitalizations, with one study finding that "higher temperatures may trigger bipolar disorder relapses that require hospital admission, and higher expositions to sunlight may increase the risk of manic episodes."
There are certain reasons as to why these psychiatric hospitalizations surge in the summer, including body inflammation, which can impact the circadian rhythm, and changes in sleep schedule due to the heat -- which could help "trigger a manic or depressive episode" for people with bipolar disorder, Rebecca Barbee, a psychiatric physician's assistant at Southlake Psychiatry in North Carolina, told ABC News.
What is transcranial magnetic stimulation?
Transcranial magnetic stimulation, or TMS, is a noninvasive form of brain stimulation. TMS devices operate completely outside of the body and affect central nervous system activity by applying powerful magnetic fields to specific areas of the brain that we know are involved in depression. TMS doesn’t require anesthesia and it is generally exceptionally well tolerated as compared to the side effects often seen with medications and ECT. The most common side effect is headache during or after treatment. A rare but serious side effect is seizures, and TMS may not be appropriate for people at high risk such as those with epilepsy, a history of head injury, or other serious neurologic issues.
DOES TMS WORK?
Approximately 50% to 60% of people with depression who have tried and failed to receive benefit from medications experience a clinically meaningful response with TMS. About one-third of these individuals experience a full remission, meaning that their symptoms go away completely. It is important to acknowledge that these results, while encouraging, are not permanent. Like most other treatments for mood disorders, there is a high recurrence rate. However, most TMS patients feel better for many months after treatment stops, with the average length of response being a little more than a year. Some will opt to come back for subsequent rounds of treatment. For individuals who do not respond to TMS, ECT may still be effective and is often worth considering.
WHAT IS TMS THERAPY LIKE?
Reality: It is extremely difficult to overdose on Suboxone alone. It is much more difficult to overdose on Suboxone compared to other opiates, because Suboxone is only a partial opiate receptor agonist, so there is a built-in "ceiling" effect. This means there is a limit to how much the opioid receptors can be activated by Suboxone, so there isn’t as great a risk of slowed breathing compared with potent opiates such as heroin, oxycodone, or morphine. When people do overdose on Suboxone, it is almost always because they are mixing it with sedatives such as benzodiazepines, medicines that also slow breathing.
CAN TMS HELP WITH OTHER CONDITIONS?
TMS is being studied extensively across disorders and even disciplines with the hope that it will evolve into new treatments for neurological disorders, pain management, and physical rehabilitation in addition to psychiatry. There are currently large clinical trials looking at the effectiveness of TMS in conditions such as pediatric depression, bipolar disorder, obsessive-compulsive disorder, smoking cessation, and post-traumatic stress disorder. While promising avenues for research, TMS for these conditions is not yet approved and would be considered "off-label."
Request an appointment here: https://americanpsychiatricgroup.com/contact/ or call American Psychiatric Group at +(410) 600-3500 for an appointment in our Baltimore or Columbia, MD office.
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