New therapy for treatment-resistant depression makes debut at U-M

First and only program in the state to offer non-systemic and non-invasive treatment for depression offers new hope to people living with the disorder

ANN ARBOR, Mich. – The Depression Center and University of Michigan’s Department of Psychiatry are now offering a new option for the treatment of depression called Repetitive Transcrancial Magnetic Stimulation (rTMS).

“Despite advances in treating depression, more than 30 percent of patients with this disease do not benefit from or are intolerant of antidepressant medications,” says Stephan Taylor, M.D., associate professor of psychiatry and co-director of the Psychiatric Neuromodulation Program. “Now, we have the option of offering patients a non-invasive treatment for depression that is completely different from medication.”

rTMS delivers highly-focused, pulsed magnetic energy to stimulate nerve cells in an area of the brain that is linked to depression. It is non-systemic (does not circulate in the bloodstream throughout the body) and non-invasive (does not involve surgery). The treatment is a 40-minute outpatient procedure prescribed by a psychiatrist that does not require anesthesia or sedation. Patients remain awake and alert while it happens. The treatment is typically administered daily for four to six weeks.

The U-M was part of a 300-patient international clinical trial from 2004-2005 that showed that rTMS was effective and safe in the treatment of depression in one in three patients. Daniel Maixner, M.D., clinical director of the Neuromodulation Program, oversaw the study site, which involved patients who failed to see improvement from prior antidepressant medication. These patients had received about four prior antidepressant treatment attempts in the current episode, one of which was deemed to be at an adequate dose for a substantial period of time.

“Our own experience is that this treatment is well-tolerated and may be particularly helpful for patients who have not responded to or cannot tolerate medications,” Maixner says.

Over 10,000 treatments were safely performed as part of the study without the side effects that are sometimes seen with medication, which include weight gain, sexual dysfunction, nausea, dry mouth, and sedation. The most common adverse reaction related to treatment was pain or discomfort on the scalp during treatments. This side-effect was transient and mild to moderate in severity. The incidence of stimulation discomfort declined significantly after the first week of treatment. There was a less than 5% discontinuation rate due to adverse events. In the strength of the treatment effect, rTMS proved as effective as anti-depressant medications.

About the U-M Psychiatric Neuromodulation Program

The U-M Psychiatric Neuromodulation Program in the Department of Psychiatry and the U-M Depression Center translates state-of-the-art research into clinical expertise to provide the best care for patients. The Program evaluates and treats patients with a variety of approaches that go beyond medication therapy, such as rTMS, vagus nerve stimulation, and electroconvulsive therapy. Consultations for these, and other treatments for depression, are available through the Depression Center Consultation Clinic.

Our staff includes psychiatrists, neurosurgeons, researchers, psychiatric nurse practitioners, and social workers, all of whom are specialists in depression and the direct treatment of the brain. They are supported by experienced nurses, social workers, medical assistants, and administrative staff who want to ensure patient clinical experiences go smoothly.

Contact the Psychiatric Neuromodulation Program and the Depression Center Consultation Clinic at the University of Michigan at: 1-800-525-5188 or 734-764-0231.